Provider Demographics
NPI:1902804263
Name:T.E.A.M. KIDS, P.C.
Entity Type:Organization
Organization Name:T.E.A.M. KIDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:ARMENGOL
Authorized Official - Last Name:MCNEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:480-940-6111
Mailing Address - Street 1:1693 S BOULDER ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-4982
Mailing Address - Country:US
Mailing Address - Phone:480-940-6111
Mailing Address - Fax:480-893-0443
Practice Address - Street 1:1693 S BOULDER ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4982
Practice Address - Country:US
Practice Address - Phone:480-940-6111
Practice Address - Fax:480-893-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5087251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0142780OtherBC/BS
AZ621575OtherAHCCCS
AZAZ0142780OtherBC/BS