Provider Demographics
NPI:1861538688
Name:ACTIVITIES FOR DEVELOPMENT, INC.
Entity type:Organization
Organization Name:ACTIVITIES FOR DEVELOPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTTLER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:602-404-8102
Mailing Address - Street 1:20815 N 25TH PL
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-4608
Mailing Address - Country:US
Mailing Address - Phone:602-404-8102
Mailing Address - Fax:602-466-2834
Practice Address - Street 1:20815 N 25TH PL
Practice Address - Street 2:SUITE 105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4608
Practice Address - Country:US
Practice Address - Phone:602-404-8102
Practice Address - Fax:602-466-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ771065OtherAHCCCS
AZAZ0461360OtherBLUE CROSS BLUE SHIELD