Basic Information
| Provider Information | |||||||||
| NPI: | 1932567229 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RATZLAFF | ||||||||
| FirstName: | ADRIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20820 E PICKETT ST | ||||||||
| Address2: | |||||||||
| City: | QUEEN CREEK | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851429533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804341604 | ||||||||
| FaxNumber: | 6024554624 | ||||||||
| Practice Location | |||||||||
| Address1: | 20820 E PICKETT ST | ||||||||
| Address2: | |||||||||
| City: | QUEEN CREEK | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851429533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804341604 | ||||||||
| FaxNumber: | 6024554624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2016 | ||||||||
| LastUpdateDate: | 02/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 385HR2055X | 7265431 | AZ | Y | Respite Care Facility | Respite Care | Respite Care, Mental Illness, Child |
No ID Information.