ARIZONA TRAINING PROGRAM @ COOLIDGE NPI 1639323082

NPI Information

NPI: 1639323082
Provider Name: ARIZONA TRAINING PROGRAM @ COOLIDGE

Other Name: 40 SANDSTONE COURT

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
2800 N. HIGHWAY 87
COOLIDGE, AZ
ZIP 85228
Phone: (520) 723-4151
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ARIZONA TRAINING PROGRAM @ COOLIDGE is an intermediate care facility mentally retarded in Coolidge, AZ. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. ARIZONA TRAINING PROGRAM @ COOLIDGE NPI is 1639323082. The provider is registered as an organization entity type.
The provider Other Name Is 40 Sandstone Court.

The provider's business location address is:

2800 N. HIGHWAY 87
COOLIDGE, AZ
ZIP 85228
Phone: (520) 723-4151

The provider's authorized official is Barbara Brent .
The authorized official title is Asst Dir, Div. Of Dev. Disabilities and has the following contact phone number (602) 542-6857.

The enumeration date for this NPI number is 11/12/2008 and was last updated on 11/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	040048	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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