MEDICARE: JIGSAW DEVELOPMENTAL SERVICES LLC

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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750749289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JIGSAW DEVELOPMENTAL SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 72772
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-1030
Country	:	US
Telephone Number	:	480-999-5666
Fax Number	:	480-999-5666

Provider Business Practice Location Address
First Line	:	2920 E CAMELBACK RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4408
Country	:	US
Telephone Number	:	480-999-5666
Fax Number	:	480-999-5666

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRETT BERNSTEIN
Credential	:
Telephone Number	:	480-999-5666

Provider Enumeration Date	:	01/28/2016
Last Update Date	:	04/28/2025

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