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Organization

PEOPLE FIRST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CONNIE SUE ROBINSON (OWNER)
(928) 759-7167
Entity
Organization

Contact information

Practice address
7291 E CONESTOGA WAY, PRESCOTT VALLEY, AZ 86314-5182
(928) 759-7167
(928) 772-7259
Mailing address
7291 E CONESTOGA WAY, PRESCOTT VALLEY, AZ 86314-5182
(928) 759-7167
(928) 772-7259

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
00795
AZ
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
00795
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
518084
AHCCCS
AZ
Enumeration date
09/28/2011
Last updated
09/28/2011
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