Provider Demographics
NPI:1215788948
Name:DOVE IN THE VALLEY LLC
Entity type:Organization
Organization Name:DOVE IN THE VALLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:YIMGNA FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DJAPA NGASSAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-284-9638
Mailing Address - Street 1:4613 E SUMMERHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4843
Mailing Address - Country:US
Mailing Address - Phone:480-284-9638
Mailing Address - Fax:
Practice Address - Street 1:6315 S 32ND GLN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5254
Practice Address - Country:US
Practice Address - Phone:480-284-9638
Practice Address - Fax:602-429-8148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility