Basic Information
| Provider Information | |||||||||
| NPI: | 1861752453 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEAD TO TOE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7220 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850117220 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5314 NORTH 7TH STREET | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022775006 | ||||||||
| FaxNumber: | 6022775042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2012 | ||||||||
| LastUpdateDate: | 05/17/2012 | ||||||||
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| AuthorizedOfficialLastName: | POZO | ||||||||
| AuthorizedOfficialFirstName: | SYLVIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SLPA | ||||||||
| AuthorizedOfficialTelephone: | 6028193300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | SLPA 7669 | AZ | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.