NPI 1053694448

Goodwill of Northern Arizona

Organisation Exclusive Provider Organization Lake Havasu City, AZ

Practice location

Address: 1990 McCulloch Blvd North, Lake Havasu City, AZ 86403
Phone: (928) 526-9188
Fax: (928) 526-9240
Mailing address: 4308 E. Route 66, Flagstaff, AZ 86004

Authorised official

Name: Liz McGinlay
Title: Vp Mission Services
Phone: (928) 526-9188

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Arizona →

Registry record

NPI: 1053694448
Entity type: Organization
NPI issued: 22 Sep 2011
Record last updated: 25 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.