Provider Demographics
NPI:1043024417
Name:H AND A SUPPORTIVE SERVICES LLC
Entity type:Organization
Organization Name:H AND A SUPPORTIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADIZA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:062-329-4949
Mailing Address - Street 1:1530 E WILLIAMS FIELD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1530 E WILLIAMS FIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-1825
Practice Address - Country:US
Practice Address - Phone:623-294-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities