| Black Family And Child Services Inc | |
|
11120 W Van Buren St Apt 2117 Avondale AZ 85323-7304 | |
| (602) 243-1773 | |
| (602) 276-1984 |
| Full Name | Black Family And Child Services Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11120 W Van Buren St Apt 2117, Avondale, Arizona |
| Authorized Official Name and Position | Mary M Black (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6022431773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Family And Child Services Inc 1522 E Southern Ave Phoenix AZ 85040-3543 Ph: (602) 243-1773 | Black Family And Child Services Inc 11120 W Van Buren St Apt 2117 Avondale AZ 85323-7304 Ph: (602) 243-1773 |
| NPI Number | 1821499104 |
|---|---|
| Provider Enumeration Date | 09/05/2014 |
| Last Update Date | 09/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821499104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4868156 (Arizona) | Primary |
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