| Catholic Charities Community Services, Inc | |
|
5119 N 19th Ave Ste G Phoenix AZ 85015-3221 | |
| (602) 749-4405 | |
| (602) 749-4406 |
| Full Name | Catholic Charities Community Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5119 N 19th Ave Ste G, Phoenix, Arizona |
| Authorized Official Name and Position | Anna Maria Smith (SR. PROGRAM MANAGER) |
| Authorized Official Contact | 6028143947 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Charities Community Services, Inc 5151 N 19th Ave Phoenix AZ 85015-3224 Ph: (480) 250-9157 | Catholic Charities Community Services, Inc 5119 N 19th Ave Ste G Phoenix AZ 85015-3221 Ph: (602) 749-4405 |
| NPI Number | 1134669229 |
|---|---|
| Provider Enumeration Date | 03/08/2017 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134669229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CSLG5979 (Arizona) | Primary |
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