Provider Demographics
NPI:1063681088
Name:SPECIAL NEEDS PEDIATRICS, INC.
Entity Type:Organization
Organization Name:SPECIAL NEEDS PEDIATRICS, INC.
Other - Org Name:SPECIAL NEEDS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SAVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP-C
Authorized Official - Phone:480-678-3760
Mailing Address - Street 1:2110 N LAZONA DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-2020
Mailing Address - Country:US
Mailing Address - Phone:480-969-3998
Mailing Address - Fax:
Practice Address - Street 1:2110 N LAZONA DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2020
Practice Address - Country:US
Practice Address - Phone:480-969-3998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-24
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities