| Centro De Amistad, Incorprorado | |
|
8202 S Avenida Del Yaqui Guadalupe AZ 85283-1024 | |
| (480) 839-2926 | |
| (480) 839-9985 |
| Full Name | Centro De Amistad, Incorprorado |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8202 S Avenida Del Yaqui, Guadalupe, Arizona |
| Authorized Official Name and Position | Rita Monroy (PRESIDENT AND CEO) |
| Authorized Official Contact | 6023933840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro De Amistad, Incorprorado 2923 N 33rd Ave Phoenix AZ 85017-5201 Ph: (602) 393-3840 | Centro De Amistad, Incorprorado 8202 S Avenida Del Yaqui Guadalupe AZ 85283-1024 Ph: (480) 839-2926 |
| NPI Number | 1497826101 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 03/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497826101 | NPI | - | NPPES |
| 125826 | Other | AZ | AHCCCS - GRP BILLER |
| 105842 | Other | AZ | AHCCCS PROVIDER # |
| A000171 | Other | AZ | MHS VENDOR NO. |
| BH-187 | Other | AZ | AZ BH LICENSE # |
| 1062002 | Other | AZ | VALUEOPTIONS BILLING # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-187 (Arizona) | Primary |
Sewa Uusim Guadalupe Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9405 S Avenida Del Yaqui, Guadalupe, AZ 85283 Phone: 480-768-2057 | |
Pascua Yaqui Centered Spirit Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9405 S Avenida Del Yaqui, Guadalupe, AZ 85283 Phone: 480-768-2021 Fax: 480-768-2053 | |
Pascua Yaqui Tribe Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9405 S Avenida Del Yaqui, Guadalupe, AZ 85283 Phone: 480-768-2000 Fax: 480-768-2053 | |
Pascua Yaqui Tribe Centered Spirit Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9405 S Avenida Del Yaqui, Guadalupe, AZ 85283 Phone: 480-768-2021 Fax: 480-768-2053 |