MEDICARE: DK ADVOCATES

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	251C00000X	Developmentally Disabled Services Day Training Agency		AZ

General Provider Information

NPI Number	:	1275683054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DK ADVOCATES

Provider Business Mailing Address
First Line	:	1502 E BROADWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-5827
Country	:	US
Telephone Number	:	520-790-7677
Fax Number	:	520-790-7786

Provider Business Practice Location Address
First Line	:	2106 N 24TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-2796
Country	:	US
Telephone Number	:	602-277-5787
Fax Number	:	602-277-7377

Authorized Official
Title or Position	:	PRESIDENT, CEO
Name	:	MS. DOROTHY E KRET
Credential	:	MRA, CRC, CDMS, CCM
Telephone Number	:	520-790-7677

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	08/26/2008

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