Doctor Name: | JOEL CHILDS |
NPI Number: | 1649536251 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 3852 |
Business Practice Address: | 9367 Chippewa Drive Hereford, AZ - 85615 |
Business Phone Number: | 5203789415 |
Business Fax Number: | |
Mailing Address: | 9367 Chippewa Drive, HEREFORD |
State: | AZ |
Postal Code: | 85615 |
Phone Number: | 5203789415 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2012 |
NPI Last Update Date: | 04/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385HR2055X |
License Number: | 3852 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | Respite Care, Mental Illness, Child |
Taxonomy Definition: | A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |