Organization · NPI-2

Community Medical Services IV LLC

Counselor, Addiction (Substance Use Disorder) · Bullhead City, AZ

NPI number1710115928
StatusActive
Last updated in NPPESJun 25, 2009

Details

NPI
1710115928
Entity type
Organization (NPI-2)
Legal business name
Community Medical Services IV LLC
Organization subpart
No
Enumeration date
Jun 25, 2009
Last updated
Jun 25, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)BH-906AZYes

Practice location

809 Hancock Rd Ste 1
Bullhead City, AZ 86442-5045

Phone 928-775-7088 · Fax 928-775-7099

Mailing address

3825 N 24th St
Phoenix, AZ 85016-6512

Authorized official

Keely N Torres
Quality Improvement
6022488886

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