Kenny Jacobs Valid NPI
Individual provider · Child Mental Illness Respite Care · Phoenix, AZ
- NPI
- 1447324397
- Type
- Individual (Type 1)
- Primary specialty
- Child Mental Illness Respite Care (Respite Care)
- Specialty group
- Respite Care Facility
- Taxonomy code
- 385HR2055X
- License number
- 10730 (AZ)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-11-20
- Last updated
- 2007-07-08
Practice location
8010 W Hilton Ave
Phoenix, AZ 85043-7420
(623) 322-5288