Organization
BOYS & GIRLS CLUB OF SANTA CRUZ COUNTY, INC.
Active
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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