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Organization

PORTABLE PRACTICAL EDUCATIONAL PREPARATION, INC

Active
Parent organization
PORTABLE PRACTICAL EDUCATIONAL PREPARATION, INC
Other names
Encompass
Organization subpart
Yes

Provider details

NPI number
Legal business name
PORTABLE PRACTICAL EDUCATIONAL PREPARATION, INC
Authorized official
GINA JUDY MAOM (CAO)
(520) 594-6499
Entity
Organization

Contact information

Practice address
901 E 46TH ST, TUCSON, AZ 85713-5008
(520) 594-6499
(520) 622-0605
Mailing address
901 E 46TH ST, TUCSON, AZ 85713-5008
(520) 594-6499
(520) 622-0605

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
AZ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007361
AHCCCS
AZ
Enumeration date
09/10/2010
Last updated
09/10/2010
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