| Kaleidoscope Llc | |
|
41288 N Cambria Dr San Tan Valley AZ 85140-3173 | |
| (480) 504-3329 | |
| Not Available |
| Full Name | Kaleidoscope Llc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 41288 N Cambria Dr, San Tan Valley, Arizona |
| Authorized Official Name and Position | Rabiya Trotter (ADMINISTRATOR) |
| Authorized Official Contact | 4805043329 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaleidoscope Llc 4051 E Gail Ct Gilbert AZ 85296-9646 Ph: (480) 862-4855 | Kaleidoscope Llc 41288 N Cambria Dr San Tan Valley AZ 85140-3173 Ph: (480) 504-3329 |
| NPI Number | 1740819085 |
|---|---|
| Provider Enumeration Date | 04/08/2020 |
| Last Update Date | 04/08/2020 |
| Certification Date | 04/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740819085 | NPI | - | NPPES |
| BH5381 | Other | AZ | AZBHS |
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