GOODWILL OF NORTHERN ARIZONA (NPI# 1477836880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477836880 |
| Entity Type | Organization |
| Organization Name | GOODWILL OF NORTHERN ARIZONA |
| Practice Address |
2369 Airway Avenue Kingman AZ 86401 |
| Mailing Address |
4308 E Rte 66 Flagstaff AZ 86004 |
| Practice Telephone | 9285269188 |
| Practice Fax Number | 9285269240 |
| Mailing Telephone | 9285269188 |
| Mailing Fax Number | 9285269240 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2015-11-20 |
| Authorized Official Name | LIZ MCGINLAY (VP MISSION SERVICES) |
| Authorized Official Telephone | 9285269188 |
| Authorized Official Credential | BS ED GCDF |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 302F00000X | Exclusive Provider Organization | Managed Care Organizations | ||
| Y | 251V00000X | Voluntary or Charitable | AZ | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| 1104067008 | Goodwill of Northern Arizona | Voluntary or Charitable | 2225 N Steves Blvd, Flagstaff, AZ 86004-6115 | 2009-03-23 |
| Street Address |
2369 AIRWAY AVENUE |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1225334840 | Sharmila Parvathaneni | Internal Medicine | 2901 N Stockton Hill Rd Ste B, Kingman, AZ 86401 | 2011-01-28 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972633675 | Fsl Programs | Voluntary or Charitable | 1776 Airway B, Kingman, AZ 86401 | 2007-03-06 |
| 1316077845 | Fsl Programs | Voluntary or Charitable | 1776 Airway B, Kingman, AZ 86401 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619504602 | Cherish Families | Voluntary or Charitable | 280 W. Township Ave, Colorado City, AZ 86021 | 2020-03-27 |
| 1083270854 | Vision With Wings | Voluntary or Charitable | 9617 N. Metro Pkwy West, Ste. 1214, Phoeniz, AZ 85051 | 2019-05-16 |
| 1518457290 | Raising Special Kids | Voluntary or Charitable | 5025 E Washington St Ste 204, Phoenix, AZ 85034-7439 | 2018-05-17 |
| 1144735994 | College of Consent | Voluntary or Charitable | 4016 E Covina St, Mesa, AZ 85205-9317 | 2017-12-01 |
| 1528502069 | Therapeutic Ranch for Animaks and Kids (trak) | Voluntary or Charitable | 3250 E Allen Rd, Tucson, AZ 85718-6663 | 2016-12-16 |
| 1760934988 | Patrick Wayne Stewart | Voluntary or Charitable | 1621 E Jacinto Ave, 6895, Mesa, AZ 85204-6895 | 2016-11-04 |
| 1285086264 | Cares Ministries Intl | Voluntary or Charitable | 4538 W Aster Dr, Glendale, AZ 85304-2149 | 2016-07-01 |
| 1700236296 | Youth Education and Social Services | Voluntary or Charitable | 888 S 165th Ln, Goodyear, AZ 85338-6013 | 2016-06-15 |
| 1629485180 | East Valley Adult Resources | Voluntary or Charitable | 45 W University Dr, Mesa, AZ 85201-5831 | 2014-07-16 |
| 1326385899 | Aviva Children's Services | Voluntary or Charitable | 153 S Plumer Ave, Tucson, AZ 85719-6300 | 2013-01-03 |
| Find all providers with the same taxonomy | ||||
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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.