Organization
GILA RIVER INDIAN COMMUNITY DEPARTMENT OF HUMAN SERVICES
Active
Organization
GILA RIVER INDIAN COMMUNITY DEPARTMENT OF HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN THOMAS CUMMINGS MA, LISAC, LPC (DIRECTOR)
(520) 796-3802
Entity
Organization
Contact information
Practice address
3850 N. 16 STREET, LAVEEN, AZ 85339
(520) 796-3860
(520) 796-3801
Mailing address
PO BOX 602, LAVEEN, AZ 85339-0602
(520) 796-3860
(520) 796-3801
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074165
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
AZ
01
—
411673
ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
AZ
Enumeration date
04/06/2009
Last updated
04/06/2009
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