Organization
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Active
Other names
Maricopa Integrated Health System
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN KIRKLAND (PFS DIRECTOR)
(602) 344-8178
Entity
Organization
Contact information
Practice address
2525 E ROOSEVELT ST, PHOENIX, AZ 85008-4948
(602) 344-8178
(602) 344-8122
Mailing address
PO BOX 29670, PHOENIX, AZ 85038-9670
(602) 344-8178
(602) 344-8122
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
H3673
AZ
261QM0850X
Adult Mental Health Clinic/Center
Primary
H3673
AZ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
H3673
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020107
—
AZ
01
—
189350800
US DEPT OF LABOR
AZ
01
—
29517
PHOENIX INDIAN MEDICAL CENTER
AZ
01
—
50005
EVERCARE CHOICE
AZ
01
—
631935
AETNA
AZ
01
—
AZ0205850
BLUE CROSS BLUE SHIELD
AZ
01
—
AZ0947
HEALTHNET OF AZ
AZ
Enumeration date
02/16/2016
Last updated
07/17/2017
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