PEOPLE OF COLOR NETWORK (NPI# 1194706986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194706986 |
| Entity Type | Organization |
| Organization Name | PEOPLE OF COLOR NETWORK |
| Practice Address |
77 E.thomas Road Suite 230 Phoenix AZ 85012-3100 |
| Mailing Address |
77 East Thomas Road Suite 230 Phoenix AZ 85012-3100 |
| Practice Telephone | 6022533084 |
| Practice Fax Number | 6022533732 |
| Mailing Telephone | 6022533084 |
| Mailing Fax Number | 6022533732 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2011-10-04 |
| Authorized Official Name | MANUEL TOMAS LEON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6022533084 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
BH-2585 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS PROVIDER NUMBER | 703547 | 01 |
| AZ | ARIZONA BEHAVIORAL HEALTH | BH2828 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043240435 | People of Color Network | Case Management | 609 N 2nd Ave, Phoenix, AZ 85003-1653 | 2006-07-03 |
| 1396075156 | People of Color Network | Case Management | 4520 N Central Ave, Suite 555 and 565, Phoenix, AZ 85012-1828 | 2009-12-30 |
| 1235373960 | People of Color Network | Clinic/Center | 1300 N Central Ave, Phoenix, AZ 85004-1722 | 2009-04-24 |
| 1518101237 | People of Color Network | Clinic/Center | 310 S Extension Rd, Mesa, AZ 85210-1292 | 2009-04-24 |
| 1336383066 | People of Color Network | Clinic/Center | 1035 E Jefferson St, Phoenix, AZ 85034-2295 | 2009-04-24 |
| 1881838514 | People of Color Network | Clinic/Center | 1540 W Van Buren St, Phoenix, AZ 85007-2414 | 2009-04-24 |
| Street Address |
77 E.THOMAS ROAD SUITE 230 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356712772 | Maurie S Comenzo | Clinic/Center | 11024 North 28th Drive/suite #200, Lake Biltmore Corporate Center, Phoenix, AZ 85020 | 2015-10-12 |
| 1730428517 | Arizona's Children Association | Clinic/Center | 7910 W Thomas Rd, Suite 103, Phoenix, AZ 85033-4829 | 2013-02-13 |
| 1497964662 | Arizona Child Psychiatry, PC | Clinic/Center | 11260 N Tatum Blvd, Suite 140, Phoenix, AZ 85028-2307 | 2007-05-22 |
| 1811082779 | Arizona's Children Association | Clinic/Center | 3636 N Central Ave Ste 300, Phoenix, AZ 85012 | 2006-10-04 |
| 1306939368 | The Devereux Foundation | Clinic/Center | 2320 W Peoria Ave Ste C111, Phoenix, AZ 85029-4715 | 2006-10-02 |
| 1295784817 | Terros, Inc. | Clinic/Center | 4909 E Mcdowell Rd, Phoenix, AZ 85008-7735 | 2006-05-09 |
| 1548764657 | Maricopa County Special Heallth Care District | Clinic/Center | 4011 N 51st Ave, Phoenix, AZ 85031-2601 | 2018-03-22 |
| 1578912093 | Arizona's Children Association | Clinic/Center | 7910 W Thomas Rd, Ste. 112, Phoenix, AZ 85033-4830 | 2016-06-06 |
| 1851750137 | Maricopa County Special Health Care District | Clinic/Center | 33 W Tamarisk St, Phoenix, AZ 85041-2422 | 2016-02-16 |
| 1992866834 | Terros Health | Clinic/Center | 3864 N 27th Ave, Phoenix, AZ 85017-4703 | 2006-12-13 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.