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Organization

ARIZONA STATE UNIVERSITY

Active
Parent organization
ARIZONA STATE UNIVERSITY
Other names
ASU Breaking the Cycle Community Healthcare
Organization subpart
Yes

Provider details

NPI number
Legal business name
ARIZONA STATE UNIVERSITY
Authorized official
DR. DENISE GIANNASCOLI LINK NURSE PRACTITIONER (ASSOC. DEAN FOR CLINICAL PRACTICE)
(602) 496-0893
Entity
Organization

Contact information

Practice address
1124 N 3RD ST, PHOENIX, AZ 85004-1805
(602) 523-9275
(602) 258-4345
Mailing address
500 N 3RD ST, PHOENIX, AZ 85004-2135
(602) 523-9275

Taxonomy

Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
AZ

Other

Enumeration date
10/30/2007
Last updated
08/21/2009
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