Organization
AZ CENTER FOR CHANGE
Active
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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