Organization
MAKING A DIFFERENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WHEATON JR. (CEO)
(602) 505-1468
Entity
Organization
Contact information
Practice address
6437 S 21ST PL, PHOENIX, AZ 85042-4652
(602) 276-6557
Mailing address
6437 S 21ST PL, PHOENIX, AZ 85042-4652
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH2728
AZ
Other
Enumeration date
04/12/2007
Last updated
06/26/2008
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