Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KEONI K HENSON

Active Sole Proprietor

Intellectual Disabilities Residential Treatment Facility · APACHE JUNCTION, AZ

Registration Details

NPI Number: 1356026819
Provider Type: Individual
Gender: Male
NPI Issued: Jun 21, 2023 (2.8347386992379 yrs)
Last Updated: Jun 21, 2023
Sole Proprietor: Yes

Practice Information

Address: 1711 E BARNACLE AVE

APACHE JUNCTION, AZ, 851193796
Browse AZ providers · Browse ZIP 85119
Phone: 7754122351
Primary Specialty: Intellectual Disabilities Residential Treatment Facility
320600000X

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.