Organization
GOMPER'S CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK JACOBY (EXECUTIVE DIRECTOR)
(602) 336-0061
Entity
Organization
Contact information
Practice address
6601 N 27TH AVE, PHOENIX, AZ 85017-1219
(602) 336-0061
(602) 336-0249
Mailing address
6601 N 27TH AVE, PHOENIX, AZ 85017-1219
(602) 336-0061
(602) 336-0249
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
AHCCCS ID 811720
AZ
Other
Enumeration date
04/27/2006
Last updated
08/22/2020
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