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Organization
COPE COMMUNITY SERVICES, INC.
Active
Organization
COPE COMMUNITY SERVICES, INC.
Active
Other names
Fifth Street Integrated Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY COOK (CHIEF EXECUTIVE OFFICER)
(520) 792-3293
Entity
Organization
Contact information
Practice address
5401 E 5TH ST, TUCSON, AZ 85711-2333
(520) 792-3293
(520) 792-4336
Mailing address
1477 W COMMERCE CT, TUCSON, AZ 85746-6016
(520) 792-3293
(520) 792-4336
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
OTC6987
AZ
251B00000X
Case Management Agency
OTC6987
AZ
251S00000X
Community/Behavioral Health Agency
OTC6987
AZ
261QC1500X
Community Health Clinic/Center
OTC6987
AZ
261QM2800X
Methadone Clinic
Primary
OTC6987
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031601
—
AZ
Enumeration date
01/29/2015
Last updated
08/27/2021
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