Organization
GOODWILL OF NORTHERN ARIZONA
Active
Organization
GOODWILL OF NORTHERN ARIZONA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZ MCGINLAY B.S. ED. GCDF (VP MISSION SERVICES)
(928) 526-9188
Entity
Organization
Contact information
Practice address
1990 MCCULLOCH BLVD NORTH, LAKE HAVASU CITY, AZ 86403
(928) 526-9188
(928) 526-9240
Mailing address
4308 E. ROUTE 66, FLAGSTAFF, AZ 86004
(928) 526-9188
(928) 526-9274
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/22/2011
Last updated
05/25/2016
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