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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