# COMMUNITY NETWORK AND FELLOW

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649452251
- **Authorized official:** KISHA BERNICE SPELLMAN (FACULTY ADMINISTRATOR)
- **Authorized official phone:** (623) 533-1689

## Contact information

- **Practice address:** 14019 N 149TH DR, SURPRISE, AZ 85379-6012
- **Practice address phone:** (623) 533-1689
- **Practice address fax:** (623) 547-6210
- **Mailing address:** 14019 N 149TH DR, SURPRISE, AZ 85379-6012
- **Mailing address phone:** (623) 533-1689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | BH2872 | AZ | Yes |

## Other

- **Enumeration date:** 12/05/2007
- **Last updated:** 12/05/2007