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General NPI Number Information
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NPI Number | 1841643632
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Entity Type | Organization
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Legal Business Name | THE PHOENIX CHILDREN'S CENTER, LTD
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 1661 E CAMELBACK RD STE 170
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City | PHOENIX
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State | AZ
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Zip | 85016-3911
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Country | US
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Telephone | 602-279-7767
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Fax | 602-274-1552
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Provider Business Mailing Address
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Address Line | 1661 E CAMELBACK RD STE 170
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City | PHOENIX
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State | AZ
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Zip | 85016-3911
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Country | US
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Telephone | 602-279-7767
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Fax | 602-274-1552
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JENNIFER LYNN WILLIAMS
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Credential |
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Telephone | 602-279-7767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | AP8802
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License Number State | AZ
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