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Organization

BOYS & GIRLS CLUB OF SANTA CRUZ COUNTY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VICKI LEE BARDEN (EXECUTIVE DIRECTOR)
(520) 287-3733
Entity
Organization

Contact information

Practice address
590 N TYLER AVE, NOGALES, AZ 85621-2300
(520) 287-3733
(520) 287-3530
Mailing address
590 N TYLER AVE, NOGALES, AZ 85621-2300
(520) 287-3733
(520) 287-3530

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
CSA06ADHS0146
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
761793
AHCCCS
AZ
Enumeration date
09/13/2006
Last updated
08/22/2020
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