Lori Zink
Individual provider Active NPI Child Mental Illness Respite Care · Parks, AZ
NPI 1255640702 · NPPES record last updated Oct 1, 2010
Key facts
- NPI
- 1255640702
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child Mental Illness Respite Care 385HR2055X
- License
- 1420774 (AZ)
- Practice address
- 13126 Trinity Ranch Road
Parks, AZ 86018-0335 - Phone
- (928) 221-7830
- NPI assigned
- Oct 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1420774 | AZ | MD | Child Mental Illness Respite Care |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child Mental Illness Respite Care | 385HR2055X | 1420774 | AZ | Yes |
Addresses
Primary practice location
13126 Trinity Ranch Road
Parks, AZ 86018-0335
Mailing address
PO Box 50335
Parks, AZ 86018-0335
Phone (928) 221-7830
Other providers in Parks, AZ
All providers in Parks, AZ · Child Mental Illness Respite Care in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.