Healthcare Provider Details

I. General information

NPI: 1336344647
Provider Name (Legal Business Name): MARC COMMUNITY RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 N COUNTRY CLUB DR
MESA AZ
85201-4108
US

IV. Provider business mailing address

924 N COUNTRY CLUB DR
MESA AZ
85201-4108
US

V. Phone/Fax

Practice location:
  • Phone: 480-969-3800
  • Fax: 480-644-1577
Mailing address:
  • Phone: 480-969-3800
  • Fax: 480-644-1577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: JOHN MOORE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 480-969-3800