Organization
MAGELLAN HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATANYA KING LISAC0821 (COUNSELOR)
(602) 252-6731
Entity
Organization
Contact information
Practice address
1035 E JEFFERSON ST, SUITE A, PHOENIX, AZ 85034-2295
(602) 252-6731
(602) 252-5928
Mailing address
1035 E JEFFERSON ST, SUITE A, PHOENIX, AZ 85034-2295
(602) 252-6731
(602) 252-5928
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
LISAC0821
AZ
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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