Provider Demographics
NPI:1699330241
Name:EMEKA, CHARITY ADAEZE
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:ADAEZE
Last Name:EMEKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 E CLARK DR # 1275
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-6880
Mailing Address - Country:US
Mailing Address - Phone:480-559-4469
Mailing Address - Fax:
Practice Address - Street 1:1275 E CLARK DR # 1275
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-6880
Practice Address - Country:US
Practice Address - Phone:480-559-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child