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NPI Code Detail

MEDICARE: ARIZONA AUTISM CHARTER SCHOOLS, INC.

MEDICARE: ARIZONA AUTISM CHARTER SCHOOLS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1376932103
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA AUTISM CHARTER SCHOOLS, INC.
Provider Business Mailing Address
First Line : 4433 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4139
Country : US
Telephone Number : 602-882-5544
Fax Number :
Provider Business Practice Location Address
First Line : 4433 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4139
Country : US
Telephone Number : 602-882-5544
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF SPECIAL EDUCATION
Name : MS. ROSETTA MARIE HICKS
Credential :
Telephone Number : 602-882-5544
Provider Enumeration Date : 01/16/2015
Last Update Date : 01/16/2015

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Directions to “ARIZONA AUTISM CHARTER SCHOOLS, INC. ” Practice Location

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