Provider Demographics
NPI:1689902801
Name:ARIZONA FOUNDATION FOR SOCIAL JUSTICE CHILDREN AND YOUTH SERVICES
Entity Type:Organization
Organization Name:ARIZONA FOUNDATION FOR SOCIAL JUSTICE CHILDREN AND YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:AJAGBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-243-8893
Mailing Address - Street 1:18298 N JAMESON CT
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-4627
Mailing Address - Country:US
Mailing Address - Phone:480-243-8893
Mailing Address - Fax:
Practice Address - Street 1:18298 N JAMESON CT
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-4627
Practice Address - Country:US
Practice Address - Phone:480-243-8893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency