Organization
MAGELLAN HEALTH SERVICES OF ARIZONA, INC
Active
Other names
Maricopa Clinic Gateway
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD T CLARKE (CHIEF EXECUTIVE OFFICER)
(602) 797-8345
Entity
Organization
Contact information
Practice address
5222 E BASELINE RD, GILBERT, AZ 85234-2963
(602) 273-2300
Mailing address
4129 E VAN BUREN ST STE 250, PHOENIX, AZ 85008-6939
(602) 273-2300
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
BH3281
AZ
Other
Enumeration date
03/04/2009
Last updated
03/04/2009
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