| Community Intervention Associates | |
|
1516 Ocotillo Avenue Parker AZ 85344-0000 | |
| (928) 669-5319 | |
| (928) 669-5368 |
| Full Name | Community Intervention Associates |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1516 Ocotillo Avenue, Parker, Arizona |
| Authorized Official Name and Position | Fred R Cogburn (CEO) |
| Authorized Official Contact | 9283760026 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Intervention Associates 2851 S Avenue B Bldg 4 Yuma AZ 85364-7726 Ph: (928) 376-0026 | Community Intervention Associates 1516 Ocotillo Avenue Parker AZ 85344-0000 Ph: (928) 669-5319 |
| NPI Number | 1255663423 |
|---|---|
| Provider Enumeration Date | 02/12/2010 |
| Last Update Date | 08/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255663423 | NPI | - | NPPES |
| 750372 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH3488 (Arizona) | Secondary |
| 251S00000X | Community/behavioral Health | BH-3994 (Arizona) | Primary |
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