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301 E 4th St Ste. A & B Safford AZ 85546-2074 | |
| (928) 792-4242 | |
| (928) 428-3885 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 301 E 4th St, Safford, 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 |
|---|---|
Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | 301 E 4th St Ste. A & B Safford AZ 85546-2074 Ph: (928) 792-4242 |
| NPI Number | 1619279155 |
|---|---|
| Provider Enumeration Date | 12/02/2010 |
| Last Update Date | 04/20/2020 |
| Certification Date | 04/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619279155 | NPI | - | NPPES |
| 232459 | Medicaid | AZ | |
| OTC8052 | Other | AZ | BUREAU OF MEDCIAL FACILITIES LICENSING |
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