Doctor Name: | DANIEL GRANTHAN |
NPI Number: | 1992967988 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 8637 |
Business Practice Address: | 14500 Crooked Skya Arivaca, AZ - 856010264 |
Business Phone Number: | 5203989151 |
Business Fax Number: | |
Mailing Address: | Po Box 264, ARIVACA |
State: | AZ |
Postal Code: | 856010264 |
Phone Number: | 5203989151 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2008 |
NPI Last Update Date: | 06/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385HR2055X |
License Number: | 8637 |
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. |