Provider Demographics
NPI:1851515241
Name:PARK PLACE OUTREACH AND COUNSELING CENTERS INC
Entity type:Organization
Organization Name:PARK PLACE OUTREACH AND COUNSELING CENTERS 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:LINAFELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-466-8850
Mailing Address - Street 1:PO BOX 2779
Mailing Address - Street 2:
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
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:2007-04-13
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH2153322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children