Provider Demographics
NPI:1679818314
Name:NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
Entity Type:Organization
Organization Name:NEIGHBORHOOD OUTREACH ACCESS TO HEALTH
Other - Org Name:NOAH
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMENDARIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-882-6073
Mailing Address - Street 1:3634 N DRINKWATER BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5622
Mailing Address - Country:US
Mailing Address - Phone:480-882-6073
Mailing Address - Fax:
Practice Address - Street 1:15833 N 29TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3704
Practice Address - Country:US
Practice Address - Phone:602-449-2811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG99162Medicare PIN
AZ08WCHPZ01Medicare PIN
AZZ118174Medicare PIN