| NPI | 1669553145 |
|---|---|
| Former Legal Business Name | EASTER SEALS ARIZONA |
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN MEDORO Chief Operating Officer 480-222-4104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: AZ 679160) |
| Additional Taxonomies | 251E00000X Home Health (Licence: AZ 679160) |
| 251S00000X Community/Behavioral Health (Licence: AZ 679160) | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-10-25 |