Provider Demographics
NPI:1104981935
Name:UYI DEVELOPMENTAL CENTER FOR CHILDREN
Entity type:Organization
Organization Name:UYI DEVELOPMENTAL CENTER FOR CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:AGHATISE
Authorized Official - Last Name:AYIYI
Authorized Official - Suffix:SR
Authorized Official - Credentials:BACHELOR DEGREE ADMI
Authorized Official - Phone:602-301-0214
Mailing Address - Street 1:5270 N 59TH AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-6764
Mailing Address - Country:US
Mailing Address - Phone:623-934-5291
Mailing Address - Fax:623-934-5291
Practice Address - Street 1:6202 W OREGON AVE
Practice Address - Street 2:5753 48TH LANE
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-6632
Practice Address - Country:US
Practice Address - Phone:602-301-0214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH2362 BH2361320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities