1225326796 NPI number — MARC COMMUNITY RESOURCES, INC.

Table of content: BILLIE JEAN HEISHMAN PTA (NPI 1770055964)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225326796 NPI number — MARC COMMUNITY RESOURCES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARC COMMUNITY RESOURCES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225326796
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
924 N COUNTRY CLUB DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85201-4108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-969-3800
Provider Business Mailing Address Fax Number:
480-644-1557

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
737 W GUADALUPE RD
Provider Second Line Business Practice Location Address:
SUITE 123 AND SUITE 124
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85210-7703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-969-3800
Provider Business Practice Location Address Fax Number:
480-222-3221
Provider Enumeration Date:
07/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
FRANCZAK
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATIONS OFFICER OF BHS
Authorized Official Telephone Number:
480-969-3800

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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