| Centro De Amistad, Incorporado | |
|
2923 N 33rd Ave Phoenix AZ 85017-5201 | |
| (602) 393-3840 | |
| (602) 393-3842 |
| Full Name | Centro De Amistad, Incorporado |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2923 N 33rd Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Rita Monroy (PRESIDENT AND CEO) |
| Authorized Official Contact | 4808392926 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro De Amistad, Incorporado 8202 S Avenida Del Yaqui Guadalupe AZ 85283-1024 Ph: (480) 839-2926 | Centro De Amistad, Incorporado 2923 N 33rd Ave Phoenix AZ 85017-5201 Ph: (602) 393-3840 |
| NPI Number | 1467523183 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 12/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467523183 | NPI | - | NPPES |
| 1062007 | Other | AZ | VO BILLING NUMBER |
| 957409 | Other | AZ | AHCCCS PROVIDER NO. |
| BH-2504 | Other | AZ | AZ BH LICENSE NO. |
| 600252357 | Other | AZ | MAGELLAN MIS# |
| A004334 | Other | AZ | MHS VENDOR NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-3759 (Arizona) | Primary |
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