Organization
COMMUNITY INTERVENTION ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE RAMON BUCIO LPC (CLINICAL SUPERVISOR)
(928) 376-0026
Entity
Organization
Contact information
Practice address
2851 S AVENUE B, BLDG 4, YUMA, AZ 85364-7726
(928) 376-0026
(928) 782-2298
Mailing address
2851 S. AVE. B., BLDG 4, YUMA, AZ 85364-0710
(928) 376-0026
(928) 782-2298
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
LPC-14075
AZ
251S00000X
Community/Behavioral Health Agency
Primary
LPC-14075
AZ
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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