Provider Demographics
NPI:1942372016
Name:AID TO ADOPTION OF SPECIAL KIDS
Entity Type:Organization
Organization Name:AID TO ADOPTION OF SPECIAL KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-930-4414
Mailing Address - Street 1:2320 N. 20TH ST.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-254-2275
Mailing Address - Fax:602-212-2564
Practice Address - Street 1:2320 N. 20TH ST.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006
Practice Address - Country:US
Practice Address - Phone:602-254-2275
Practice Address - Fax:602-212-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4217251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAHCCCS-835283Medicaid