| People Of Color Network | |
|
77 E.thomas Road Suite 230 Phoenix AZ 85012-3100 | |
| (602) 253-3084 | |
| (602) 253-3732 |
| Full Name | People Of Color Network |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 77 E.thomas Road, Phoenix, Arizona |
| Authorized Official Name and Position | Manuel Tomas Leon (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6022533084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| People Of Color Network 77 East Thomas Road Suite 230 Phoenix AZ 85012-3100 Ph: (602) 253-3084 | People Of Color Network 77 E.thomas Road Suite 230 Phoenix AZ 85012-3100 Ph: (602) 253-3084 |
| NPI Number | 1194706986 |
|---|---|
| Provider Enumeration Date | 11/08/2005 |
| Last Update Date | 10/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194706986 | NPI | - | NPPES |
| 703547 | Other | AZ | AHCCCS PROVIDER NUMBER |
| BH2828 | Other | AZ | ARIZONA BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | BH-2585 (Arizona) | Primary |
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