| Treatment Assessment Screening Center, Inc | |
|
2314 N 4th St Flagstaff AZ 86004-3709 | |
| (928) 526-5417 | |
| (928) 526-5615 |
| Full Name | Treatment Assessment Screening Center, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2314 N 4th St, Flagstaff, Arizona |
| Authorized Official Name and Position | Latrice Shannon Hickman (CHIEF PROGRAM OFFICER) |
| Authorized Official Contact | 6022547328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Treatment Assessment Screening Center, Inc 4016 N Black Canyon Hwy Phoenix AZ 85017-4730 Ph: (602) 254-7328 | Treatment Assessment Screening Center, Inc 2314 N 4th St Flagstaff AZ 86004-3709 Ph: (928) 526-5417 |
| NPI Number | 1801377270 |
|---|---|
| Provider Enumeration Date | 08/23/2018 |
| Last Update Date | 08/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801377270 | NPI | - | NPPES |
| OTC9085 | Other | AZ | ARIZONA DEPARTMENT OF HEALTH SERVICES OUTPATIENT TREATMENT CENTER LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC9085 (Arizona) | Primary |
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