Organization
STATE OF ARIZONA STATE DEPT OF FINANCE
Active
Organization
STATE OF ARIZONA STATE DEPT OF FINANCE
Active
Other names
Arizona State Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN F RODNEY CPA, CGFM (CHIEF FINANCIAL OFFICER)
(602) 220-6372
Entity
Organization
Contact information
Practice address
2500 E VAN BUREN ST, PHOENIX, AZ 85008-6037
(602) 220-6000
Mailing address
2500 E VAN BUREN ST, ATTN: FINANCE, PHOENIX, AZ 85008-6037
(602) 220-6000
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029331
AHCCCS- MEDICAID
—
Enumeration date
08/25/2006
Last updated
04/07/2021
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