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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
FADIL LABIB (PROGRAMS DIRECTOR)
(602) 545-6126
Entity
Organization

Contact information

Practice address
17100 E SHEA BLVD STE 225, FOUNTAIN HILLS, AZ 85268-6744
(602) 877-8072
Mailing address
17100 E SHEA BLVD STE 225, FOUNTAIN HILLS, AZ 85268-6744
(602) 877-8072

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
347E00000X
Transportation Broker
405300000X
Prevention Professional
Primary

Other

Enumeration date
12/14/2023
Last updated
12/31/2023
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