Individual
MR. DAVID SACCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7616 W COMET AVE, PEORIA, AZ 85345-0730
(623) 210-3051
Mailing address
7616 W COMET AVE, PEORIA, AZ 85345-0730
(602) 210-3051
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
4009
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
745044
AHCCCS ID NUMBER
AZ
Enumeration date
11/28/2006
Last updated
04/09/2010
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