Organization
SOMEWHERE OUT OF THE BOX
Active
Other names
Milemarkers
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COLLEEN MCSHEA (PRESIDENT)
(928) 854-5439
Entity
Organization
Contact information
Practice address
1515 LAKE HAVASU AVE N STE 100, LAKE HAVASU CITY, AZ 86404-1177
(928) 854-5439
(928) 854-5440
Mailing address
1515 LAKE HAVASU AVE N STE 100, LAKE HAVASU CITY, AZ 86404-1177
(928) 854-5439
(928) 854-5440
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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