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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