| Early Childhood Center Of Excellance | |
|
1151 16th Street Douglas AZ 85607 | |
| (520) 364-5437 | |
| Not Available |
| Full Name | Early Childhood Center Of Excellance |
|---|---|
| Speciality | Clinic/Center |
| Location | 1151 16th Street, Douglas, Arizona |
| Authorized Official Name and Position | Jonathan P Melk (CEO) |
| Authorized Official Contact | 5203641429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Early Childhood Center Of Excellance 1205 N F Ave Douglas AZ 85607-1920 Ph: (520) 364-6852 | Early Childhood Center Of Excellance 1151 16th Street Douglas AZ 85607 Ph: (520) 364-5437 |
| NPI Number | 1811472665 |
|---|---|
| Provider Enumeration Date | 09/27/2018 |
| Last Update Date | 09/01/2021 |
| Medicare PECOS PAC ID | 5395638878 |
|---|---|
| Medicare Enrollment ID | O20181012002337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811472665 | NPI | - | NPPES |
| 435308 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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