Organization
OAK STREET
Active
Organization
OAK STREET
Active
Parent organization
VO OF ARIZONA
Organization subpart
Yes
Provider details
NPI number
Legal business name
VO OF ARIZONA
Authorized official
ANGELO EDGE (CAO)
(602) 914-5859
Entity
Organization
Contact information
Practice address
2255 N 44TH ST STE 240, PHOENIX, AZ 85008-7233
(602) 914-5859
Mailing address
2255 N 44TH ST STE 240, PHOENIX, AZ 85008-7233
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
BH-1903
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805418
—
AZ
Enumeration date
04/16/2008
Last updated
04/16/2008
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