Provider Demographics
NPI:1588442438
Name:WEST INDIAN SCHOOL COMMUNITY CARE LLC
Entity type:Organization
Organization Name:WEST INDIAN SCHOOL COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:DARLING
Authorized Official - Last Name:AYOMANOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-999-0851
Mailing Address - Street 1:4525 W INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-2820
Mailing Address - Country:US
Mailing Address - Phone:623-999-0851
Mailing Address - Fax:
Practice Address - Street 1:4525 W INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-2820
Practice Address - Country:US
Practice Address - Phone:623-999-0851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)