| Community Partners Integrated Healthcare, Inc. | |
|
1021 S Kofa Ave Parker AZ 85344-5021 | |
| (928) 376-0220 | |
| (928) 669-2500 |
| Full Name | Community Partners Integrated Healthcare, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1021 S Kofa Ave, Parker, Arizona |
| Authorized Official Name and Position | Rose Mary Lopez (PRESIDENT AND CEO) |
| Authorized Official Contact | 5207211887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Partners Integrated Healthcare, Inc. Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | Community Partners Integrated Healthcare, Inc. 1021 S Kofa Ave Parker AZ 85344-5021 Ph: (928) 376-0220 |
| NPI Number | 1740517713 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 04/20/2020 |
| Certification Date | 04/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740517713 | NPI | - | NPPES |
| 232617 | Medicaid | AZ | |
| OTC8051 | Other | AZ | BUREAU OF MEDICAL FACILITIES LICENSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC8051 (Arizona) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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