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General NPI Number Information
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NPI Number | 1871812131
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Entity Type | Organization
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Legal Business Name | MY SISTER MY FRIEND
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 3340 W SOUTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85041-4308
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Country | US
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Telephone | 480-330-8468
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Fax | 602-252-1371
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Provider Business Mailing Address
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Address Line | 1325 W PIMA RD
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City | PHOENIX
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State | AZ
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Zip | 85007-4142
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Country | US
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Telephone | 602-252-1775
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Fax | 602-252-1371
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Authorized Official
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Title or Position | CEO
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Name | MRS. ANN GLOVER
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Credential |
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Telephone | 602-252-1775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State | AZ
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