Provider Demographics
NPI:1902519531
Name:CHARMING HOMES LLC
Entity Type:Organization
Organization Name:CHARMING HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:PHIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:TETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-809-5732
Mailing Address - Street 1:6418 S 70TH LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-5033
Mailing Address - Country:US
Mailing Address - Phone:520-809-5732
Mailing Address - Fax:
Practice Address - Street 1:6418 S 70TH LN
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-5033
Practice Address - Country:US
Practice Address - Phone:520-809-5732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities