MEDICARE: GROWTH PROCESS INTEGRATION, INCORPORATED

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
1	103G00000X	Clinical Neuropsychologist	3861	AZ
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist	3861	AZ
3	103TA0700X	Adult Development & Aging Psychologist	3861	AZ
4	103TC2200X	Clinical Child & Adolescent Psychologist	3861	AZ
5	103TE1100X	Exercise & Sports Psychologist	3861	AZ
6	103TF0000X	Family Psychologist	3861	AZ
7	103TF0200X	Forensic Psychologist	3861	AZ
8	103TH0004X	Health Psychologist	3861	AZ
9	103TH0100X	Health Service Psychologist	3861	AZ
10	103TP0814X	Psychoanalysis Psychologist	3861	AZ
11	103TP2701X	Group Psychotherapy Psychologist	3861	AZ
12	103TR0400X	Rehabilitation Psychologist	3861	AZ
13	106H00000X	Marriage & Family Therapist	3861	AZ
14	146D00000X	Personal Emergency Response Attendant	3861	AZ
15	103TC0700X	Clinical Psychologist	3861	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11233203	OTHER		CAQH
2	3861	OTHER	AZ	LICENSE
3	1275696924	OTHER		INDIVIDUAL NPI
4	0810002999	OTHER	VA	LICENSE

General Provider Information

NPI Number	:	1144466707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROWTH PROCESS INTEGRATION, INCORPORATED

Provider Business Mailing Address
First Line	:	3300 N MESQUITE RD
Second Line	:
City	:	COCHISE
State	:	AZ
Zip	:	85606-8729
Country	:	US
Telephone Number	:	520-826-0299
Fax Number	:	520-826-0030

Provider Business Practice Location Address
First Line	:	3300 N MESQUITE RD
Second Line	:
City	:	COCHISE
State	:	AZ
Zip	:	85606-8729
Country	:	US
Telephone Number	:	520-826-0299
Fax Number	:	520-826-0030

Authorized Official
Title or Position	:	PRESIDENT/CHIEF EXECUTIVE OFFICER
Name	:	DR. MICHAEL ANGELO BORDERS
Credential	:	PSY.D., ABPP, FAACP
Telephone Number	:	520-826-0299

Provider Enumeration Date	:	12/31/2008
Last Update Date	:	12/31/2008

Similar Medicare Providers

1275696924 — DR. MICHAEL ANGELO BORDERS PSY.D., ABPP, FAACP
Practice Location Address:

3300 N MESQUITE RD
COCHISE, AZ
85606-8729

Practice Phone: 520-826-0299
Practice Fax: 520-826-0300

1104867621 — PROF. WAYNE ROBERT MARTIN MD
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1606 N PANORAMA WAY
COCHISE, AZ
85606-8685

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1174667125 — HOUSE OF HOPE
Practice Location Address:

424 W KAIBAB WAY
COCHISE, AZ
85606-8710

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1568659399 — MS. RUTH ANN SHEETS FNP BC
Practice Location Address:

3584 N MESQUITE RD
COCHISE, AZ
85606-8769

Practice Phone: 520-826-4507
Practice Fax: 520-826-4507

1922282904 — FREDRICK DAVID BEAVER
Practice Location Address:

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85606

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1114224581 — CDE TRANSPORTATION & SERVICES
Practice Location Address:

220 W PAPAGO WAY
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