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General NPI Number Information
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NPI Number | 1447634662
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Entity Type | Organization
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Legal Business Name | MORIAH COOPERATIVE INC
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 21001 N TATUM BLVD SUITE 1630-233
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City | PHOENIX
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State | AZ
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Zip | 85050-4206
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Country | US
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Telephone | 480-779-9011
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Fax |
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Provider Business Mailing Address
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Address Line | 21001 N TATUM BLVD SUITE 1630-233
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City | PHOENIX
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State | AZ
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Zip | 85050-4206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BRETT BERNSTEIN
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Credential |
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Telephone | 480-779-9011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | AZ
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