Organization
CODAC BEHAVIORAL HEALTH SERVICES, INC.
Active
Other names
CODAC Safety Zone
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W. MARK CLARK (CEO)
(520) 327-4505
Entity
Organization
Contact information
Practice address
3550 N 1ST AVE, SUITE 100, TUCSON, AZ 85719-1770
(520) 327-4505
(520) 202-1889
Mailing address
127 S 5TH AVE, TUCSON, AZ 85701-2005
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSA06ADHS0194 2
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128640
AHCCCS ID
AZ
Enumeration date
07/23/2007
Last updated
07/23/2007
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