Organization
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Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA LEE (PROGRAM ADMINISTRATOR)
(623) 444-7963
Entity
Organization
Contact information
Practice address
1529 W MCDOWELL RD, PHOENIX, AZ 85007-1630
(602) 253-8799
(602) 253-8824
Mailing address
PO BOX 2208, PEORIA, AZ 85380-2208
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
AZ
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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