Desert Agave Homes LLC

NPI #1780275537 in Avondale, Arizona

Provider Information

NPI Number: 1780275537
Entity Type: Organization
Organization Name: Desert Agave Homes LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 3, 2021
Last Updated: Feb 3, 2021

Practice Location

Address: 810 S 124TH AVE
City: Avondale
State: Arizona
ZIP Code: 85323-8490
Phone: (623) 242-7962

Authorized Official

Name: MADISON SHAUN BROWN
Title: OWNER
Phone: (646) 460-1913

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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