| Brothers And Keepers Corporation | |
|
3947 W Kirkland Ave San Tan Valley AZ 85142-6836 | |
| (480) 630-9933 | |
| Not Available |
| Full Name | Brothers And Keepers Corporation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3947 W Kirkland Ave, San Tan Valley, Arizona |
| Authorized Official Name and Position | Eric Edward Dominguez (PROGRAM DIRECTOR) |
| Authorized Official Contact | 9092231939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brothers And Keepers Corporation 2200 E Williams Field Rd Ste 200 Gilbert AZ 85295-0764 Ph: (480) 630-9933 | Brothers And Keepers Corporation 3947 W Kirkland Ave San Tan Valley AZ 85142-6836 Ph: (480) 630-9933 |
| NPI Number | 1376159244 |
|---|---|
| Provider Enumeration Date | 09/16/2020 |
| Last Update Date | 09/16/2020 |
| Certification Date | 09/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376159244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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