Provider Demographics
NPI:1952598302
Name:KATHLEEN WILLIAMS
Entity Type:Organization
Organization Name:KATHLEEN WILLIAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:B
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-589-8354
Mailing Address - Street 1:PO BOX 91471
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85752-1471
Mailing Address - Country:US
Mailing Address - Phone:520-575-5829
Mailing Address - Fax:
Practice Address - Street 1:13750 N SEIFERT ESTATES DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85755-8654
Practice Address - Country:US
Practice Address - Phone:520-575-5829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1064314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility