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Organization

AZ CENTER FOR CHANGE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE GENCO MA (CLINICAL DIRECTOR/OWNER)
(602) 253-8488
Entity
Organization

Contact information

Practice address
4205 N 7TH AVE, 311, PHOENIX, AZ 85013-3078
(602) 253-8488
(602) 253-8340
Mailing address
4205 N 7TH AVE, 311, PHOENIX, AZ 85013-3078
(602) 253-8488
(602) 253-8340

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3486
AZ

Other

Enumeration date
12/22/2009
Last updated
09/18/2024
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