Provider Demographics
NPI:1144675307
Name:SUN CITY AREA INTERFAITH SERVICES, INC
Entity type:Organization
Organization Name:SUN CITY AREA INTERFAITH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-584-4999
Mailing Address - Street 1:PO BOX 8450
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-0124
Mailing Address - Country:US
Mailing Address - Phone:623-584-4999
Mailing Address - Fax:
Practice Address - Street 1:16752 N GREASEWOOD ST
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-3639
Practice Address - Country:US
Practice Address - Phone:623-584-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL1083D261QA0600X
AZAL2905D261QA0600X
261QA0600X
AZAL7567D261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ194879Medicaid