Organization
CATHOLIC CHARITIES COMMUNITY SERVICES, INC
Active
Organization
CATHOLIC CHARITIES COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN LANG (RESOURCE SUPPORT SPECIALIST)
(928) 864-7371
Entity
Organization
Contact information
Practice address
434 W GURLEY STREET, PRESCOTT, AZ 86301
(928) 778-2531
(928) 771-9531
Mailing address
5151 N 19TH AVE, PHOENIX, AZ 85015-3224
(480) 250-9157
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BH316
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC5874
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442265
AHCCCS
AZ
Enumeration date
11/02/2006
Last updated
07/14/2023
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