Organization
CHICANOS POR LA CAUSA, INC.
Active
Parent organization
CHICANOS POR LA CAUSA INC.
Other names
Corazon
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHICANOS POR LA CAUSA INC.
Authorized official
MR. ANDRES CONTRERAS (EXECUTIVE VICE PRESIDENT OFFICER)
(602) 257-0700
Entity
Organization
Contact information
Practice address
3639 W. LINCOLN ST., PHOENIX, AZ 85009
(602) 233-9747
(602) 352-5989
Mailing address
1112 E. BUCKEYE RD., PHOENIX, AZ 85034
(602) 257-0700
(602) 307-9752
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-0008
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590978
—
AZ
01
—
BH-0008
LICENSE
AZ
Enumeration date
09/20/2006
Last updated
06/23/2020
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