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General NPI Number Information
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NPI Number | 1508071861
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Entity Type | Organization
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Legal Business Name | PINAL GILA COMMUNITY CHILD SERVICES
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 900 N PLAZA DR
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City | APACHE JUNCTION
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State | AZ
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Zip | 85220-4110
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Country | US
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Telephone | 480-982-4516
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Fax | 480-288-9501
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Provider Business Mailing Address
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Address Line | 1750 S ARIZONA BLVD
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City | COOLIDGE
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State | AZ
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Zip | 85228-5920
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Country | US
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Telephone | 520-723-1213
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Fax | 520-723-0806
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Authorized Official
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Title or Position | ACCOUNTING SPECIALIST
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Name | MS. SUSAN LUICCI-DAVIS
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Credential |
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Telephone | 520-723-1213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State | AZ
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