Goodwill Industries-kingman

NPI 1053694448 - Exclusive Provider Organization - 302F00000X

NPI Details
NPI 1053694448
Enumeration Date 09/22/2011
Last Updated 05/25/2016
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name LIZ LIZ
Position VP MISSION SERVICES
Phone (928) 526-9188
Fax (928) 526-9240
Practice Location
1990 MCCULLOCH BLVD NORTH
LAKE HAVASU CITY AZ, 86403, US
Phone (928) 526-9188
Fax (928) 526-9240
Business Location
4308 E. ROUTE 66
FLAGSTAFF AZ, 86004, US
Phone (928) 526-9188
Fax (928) 526-9274
Toxanomy
Taxonomy Code 302F00000X
License State
License Number
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According to our database, Goodwill Industries-kingman NPI is 1053694448, taxonomy code is 302F00000X Goodwill Industries-kingman physically located at 1990 Mcculloch Blvd North, Lake Havasu City AZ, 86403. NPI Number 1033115704 has the healthcare provider type.

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1053694448 NPI number is provided on an as is basis without warranty of any kind. 1053694448 is maintained by the National Plan & Provider Enumeration System. The contents of Goodwill Industries-kingman are for informational purposes only.