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General NPI Number Information
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NPI Number | 1598980427
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Entity Type | Organization
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Legal Business Name | MEDICAL MANAGEMENT SYSTEMS, INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 7419 N 82ND LN
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City | GLENDALE
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State | AZ
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Zip | 85303-1817
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Country | US
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Telephone | 623-937-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 7419 N 82ND LN
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City | GLENDALE
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State | AZ
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Zip | 85303-1817
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Country | US
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Telephone | 623-937-9399
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | MR. CARLOS N. JORGE
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Credential | MBA
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Telephone | 602-909-9026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALH-6047
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License Number State | AZ
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