Organization
COMMUNITY INTERVENTION ASSOCIATES
Active
Other names
Community Health Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED R COGBURN (CEO)
(928) 376-0026
Entity
Organization
Contact information
Practice address
32 BLVD DEL REY DAVID, NOGALES, AZ 85621
(520) 394-7400
(520) 377-9596
Mailing address
2851 S AVE B, BLDG 4, YUMA, AZ 85364-7726
(928) 376-0026
(928) 782-2298
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
B-3771
AZ
251S00000X
Community/Behavioral Health Agency
Primary
BH-3771
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
603657
—
AZ
Enumeration date
06/03/2011
Last updated
02/12/2016
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