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Organization

GOODWILL OF NORTHERN ARIZONA

Active
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Organization

GOODWILL OF NORTHERN ARIZONA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID HIRSCH (PRESIDENT/CEO)
(928) 526-9188
Entity
Organization

Contact information

Practice address
2225 N STEVES BLVD, FLAGSTAFF, AZ 86004-6115
(928) 526-9188
(928) 526-9240
Mailing address
PO BOX 1060, FLAGSTAFF, AZ 86002-1060
(928) 526-9188
(928) 526-9240

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019522
AHCCCS
AZ
Enumeration date
03/23/2009
Last updated
03/23/2009
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