GOODWILL OF NORTHERN ARIZONA (NPI# 1104067008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104067008 |
| Entity Type | Organization |
| Organization Name | GOODWILL OF NORTHERN ARIZONA |
| Practice Address |
2225 N Steves Blvd Flagstaff AZ 86004-6115 |
| Mailing Address |
Po Box 1060 Flagstaff AZ 86002-1060 |
| Practice Telephone | 9285269188 |
| Practice Fax Number | 9285269240 |
| Mailing Telephone | 9285269188 |
| Mailing Fax Number | 9285269240 |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |
| Authorized Official Name | DAVID HIRSCH (PRESIDENT/CEO) |
| Authorized Official Telephone | 9285269188 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251V00000X | Voluntary or Charitable | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS | 019522 | 01 |
| 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 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Street Address |
2225 N STEVES BLVD |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86004-6115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387805 | Michael Joseph Oxtoby | Counselor | 2625 N. King St., Flagstaff, AZ 86004 | 2020-05-08 |
| 1083264501 | Dazhoni Elizabeth Scott | Counselor | 1500 E. Cedar Avenue #26, 2110 N. East St Apt C, Flagstaff, AZ 86004 | 2019-09-17 |
| 1760948046 | Emily Bauerle | Social Worker | 3009 N West St, Flagstaff, AZ 86004 | 2019-02-12 |
| 1992295745 | Kaibab Behavioral Services, Pllc | Behavioral Analyst | 2323 E Greenlaw Lane, Suite 12a, Flagstaff, AZ 86004 | 2018-05-17 |
| 1083115364 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 8800 Marys Drive, Flagstaff, AZ 86004 | 2018-02-22 |
| 1710391081 | Janet Coleman | Hearing Instrument Specialist | 1851 E Butler Avenue, Flagstaff, AZ 86004 | 2014-06-16 |
| 1568703163 | Mercy Timoh | Pharmacist | 4255 E. Soliere Ave., Flagstaff, AZ 86004 | 2013-03-06 |
| 1053617217 | Scott Nichols | Veterinarian | 6122 Abineau Canyon Drive, Flagstaff, AZ 86004 | 2011-02-07 |
| 1366745218 | Karoline S. Mariano | Registered Nurse | 3480 East Route 66, Flagstaff, AZ 86004 | 2010-12-15 |
| 1912209719 | Payal Parekh | Pharmacist | 1500 E Cedar, Flagstaff, AZ 86004 | 2010-11-30 |
| Find all providers in zip 86004 | ||||
| Taxonomy Code | 251V00000X |
| Grouping | Agencies |
| Classification | Voluntary or Charitable |
| Definition to come... |
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|---|---|---|---|---|
| 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.