Provider Demographics
NPI:1821001504
Name:PARK PLACE OUTREACH AND COUNSELING INC
Entity type:Organization
Organization Name:PARK PLACE OUTREACH AND COUNSELING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LINAFEITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-466-8850
Mailing Address - Street 1:PO BOX 2779
Mailing Address - Street 2:9373 W BATTAGLIA RD
Mailing Address - City:ARIZONA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85223-2779
Mailing Address - Country:US
Mailing Address - Phone:520-466-8850
Mailing Address - Fax:520-466-8851
Practice Address - Street 1:9373 W BATTAGLIA RD
Practice Address - Street 2:
Practice Address - City:ARIZONA CITY
Practice Address - State:AZ
Practice Address - Zip Code:85223-2779
Practice Address - Country:US
Practice Address - Phone:520-466-8850
Practice Address - Fax:520-466-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty