Organization
GOMPERS HABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA MARIA JENKINS (LPN SCHOOL NURSE)
(623) 227-8660
Entity
Organization
Contact information
Practice address
6601 N 27TH AVE, PHOENIX, AZ 85017-1219
(602) 336-0061
(602) 336-0249
Mailing address
6601 N 27TH AVE, PHOENIX, AZ 85017-1219
(602) 336-0061
(602) 336-0249
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
LP030525
AZ
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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