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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