Ellis, Darrell Lemont

Ellis, Darrell Lemont is an sole proprietor health care provider with primary practice located at 304 N Lincoln Ave , Casa Grande AZ 85122-4634. He recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as his primary health care specialty. Ellis, Darrell Lemont can be contacted via phone (480) 560-8924.

Contact Information

Primary practice address
304 N Lincoln Ave Casa Grande AZ 85122-4634
Phone: (480) 560-8924
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X BH-4483 Arizona

Profile Details

NPI number 1174925424
LBN Legal business name Ellis, Darrell Lemont
Credentials ADMINISTRATOR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 18th, 2014
Last updated Sep 18th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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