Organization
PEOPLE OF COLOR NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL TOMAS LEON (CHIEF EXECUTIVE OFFICER)
(602) 253-3084
Entity
Organization
Contact information
Practice address
1300 N CENTRAL AVE, PHOENIX, AZ 85004-1722
(602) 251-0650
(602) 251-0632
Mailing address
77 E THOMAS RD STE 230, PHOENIX, AZ 85012-3100
(602) 253-3084
(602) 253-3732
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444530
—
AZ
Enumeration date
04/24/2009
Last updated
10/04/2011
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