Provider Demographics
NPI:1508206343
Name:VALLEY TRAVELERS SOCIAL EXPLORATION INC.
Entity Type:Organization
Organization Name:VALLEY TRAVELERS SOCIAL EXPLORATION INC.
Other - Org Name:VALLEY TRAVELERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SELENE
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-753-8389
Mailing Address - Street 1:5242 W JESSICA LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2447
Mailing Address - Country:US
Mailing Address - Phone:602-753-8389
Mailing Address - Fax:
Practice Address - Street 1:5242 W JESSICA LN
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2447
Practice Address - Country:US
Practice Address - Phone:602-753-8389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services