NPIMap

Organization Active NPI

Goodwill of Northern Arizona

  • Exclusive Provider Organization
  • Lake Havasu City, AZ
National Provider Identifier
1053694448
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
Legal business name
GOODWILL OF NORTHERN ARIZONA
Practice address
1990 McCulloch Blvd North
Lake Havasu City, AZ 86403
Phone
(928) 526-9188
Fax
(928) 526-9240
NPI assigned
Sep 22, 2011
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Liz McGinlay, B.S. ED. GCDF
Title
VP Mission Services
Phone
(928) 526-9188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X Primary

Addresses

Primary practice location

1990 McCulloch Blvd North
Lake Havasu City, AZ 86403

Mailing address

4308 E. Route 66
Flagstaff, AZ 86004
Phone (928) 526-9188

National Provider Directory

National Provider Directory
Tax ID family
Goodwill of Northern Arizona6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1990 McCulloch Blvd N
Lake Havasu City, AZ 86403
Phone (928) 526-9188

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1053694448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 E. ROUTE 66",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86004",
            "telephone_number": "928-526-9188",
            "fax_number": "928-526-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 MCCULLOCH BLVD NORTH",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "928-526-9188",
            "fax_number": "928-526-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL OF NORTHERN ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-22",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "MCGINLAY",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "VP MISSION SERVICES",
        "authorized_official_telephone_number": "928-526-9188",
        "authorized_official_credential": "B.S. ED. GCDF"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.