Organization
CASA GRANDE UNION HSD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONAH M GILLOOLY MSW (ESS COUNSELOR)
(520) 836-8500
Entity
Organization
Contact information
Practice address
2730 N TREKELL RD, CASA GRANDE, AZ 85122-1019
(520) 836-8500
(520) 876-1199
Mailing address
2730 N TREKELL RD, CASA GRANDE, AZ 85122-1019
(520) 836-8500
(520) 876-1199
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW-12294
AZ
251S00000X
Community/Behavioral Health Agency
LISAC-11537
AZ
Other
Enumeration date
08/22/2011
Last updated
08/22/2011
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