Organization · NPI-2

Community Medical Services Arizona-Private, LLC

Clinic/Center, Methadone Clinic · Prescott Valley, AZ

NPI number1215648951

StatusActive

Last updated in NPPESFeb 10, 2024

Details

NPI: 1215648951
Entity type: Organization (NPI-2)
Legal business name: Community Medical Services Arizona-Private, LLC
Organization subpart: No
Enumeration date: Dec 13, 2022
Certification date: Feb 10, 2024
Last updated: Feb 10, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM2800X	Clinic/Center, Methadone Clinic	–	–	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
251S00000X	Community/Behavioral Health	–	–
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–

Other names

Community Medical Services Prescott Valley (Doing Business As)

Practice location

3155 N Windsong Dr Ste A
Prescott Valley, AZ 86314-2219

Phone 928-968-7400 · Fax 480-687-7361

Mailing address

8444 N 90th St Ste 100
Scottsdale, AZ 85258-4437

Phone 602-248-8886 · Fax 480-687-7361

Authorized official

Cindy Gaither
Vp Of Revenue Cycle Management
6022488886

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