Organization
BLACK FAMILY AND CHILD SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY M BLACK (CHIEF EXECUTIVE OFFICER)
(602) 243-1773
Entity
Organization
Contact information
Practice address
11120 W VAN BUREN ST APT 2117, AVONDALE, AZ 85323-7304
(602) 243-1773
(602) 276-1984
Mailing address
1522 E SOUTHERN AVE, PHOENIX, AZ 85040-3543
(602) 243-1773
(602) 276-1984
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4868156
AZ
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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