Provider Demographics
NPI:1902463565
Name:FOUR DIRECTIONS LLC
Entity Type:Organization
Organization Name:FOUR DIRECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMUALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-332-9276
Mailing Address - Street 1:PO BOX 8310
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252
Mailing Address - Country:US
Mailing Address - Phone:480-699-2344
Mailing Address - Fax:480-699-3035
Practice Address - Street 1:37724 W AMALFI AVE
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138
Practice Address - Country:US
Practice Address - Phone:480-699-2344
Practice Address - Fax:480-699-3035
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOUR DIRECTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child