Organization
JORETTA MCCOY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JORETTA MCCOY (THERAPEUTIC CARE PROVIDER)
(520) 398-3311
Entity
Organization
Contact information
Practice address
26855 S COOPERS HAWK RD, AMADO, AZ 85645-9571
(520) 398-3311
Mailing address
26855 S COOPERS HAWK RD, AMADO, AZ 85645-9571
(520) 398-3311
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
10964
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041438
—
AZ
Enumeration date
09/13/2006
Last updated
08/22/2020
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