Organization
GOODWILL OF NORTHERN ARIZONA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZ MCGINLAY BS ED GCDF (VP MISSION SERVICES)
(928) 526-9188
Entity
Organization
Contact information
Practice address
2369 AIRWAY AVENUE, KINGMAN, AZ 86401
(928) 526-9188
(928) 526-9240
Mailing address
4308 E RTE 66, FLAGSTAFF, AZ 86004
(928) 526-9188
(928) 526-9240
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
AZ
302F00000X
Exclusive Provider Organization
—
—
Other
Enumeration date
09/21/2011
Last updated
11/20/2015
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