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NPI Code Detail

MEDICARE: GOMPER'S CENTER, INC.

MEDICARE: GOMPER'S CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training AgencyAHCCCS ID 811720AZ

General Provider Information

NPI Number : 1043277569
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOMPER'S CENTER, INC.
Provider Business Mailing Address
First Line : 6601 N 27TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-1219
Country : US
Telephone Number : 602-336-0061
Fax Number : 602-336-0249
Provider Business Practice Location Address
First Line : 6601 N 27TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-1219
Country : US
Telephone Number : 602-336-0061
Fax Number : 602-336-0249
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. MARK JACOBY
Credential :
Telephone Number : 602-336-0061
Provider Enumeration Date : 04/27/2006
Last Update Date : 08/22/2020

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Directions to “GOMPER'S CENTER, INC. ” Practice Location

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