MEDICARE: ARIZONA COMMUNITY DEVELOPMENT CORP

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
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710170550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA COMMUNITY DEVELOPMENT CORP

Provider Business Mailing Address
First Line	:	2050 N WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3039
Country	:	US
Telephone Number	:	520-721-4205
Fax Number	:	520-721-4263

Provider Business Practice Location Address
First Line	:	2050 N WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3039
Country	:	US
Telephone Number	:	520-721-4205
Fax Number	:	520-721-4263

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. RAENA JANES
Credential	:
Telephone Number	:	520-721-4205

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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