Organization
VISIONS OF HOPE ARIZONA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MICHAEL RUSSO MA, M.P.H. (CHIEF EXECUTIVE OFFICER)
(602) 404-1555
Entity
Organization
Contact information
Practice address
601 W HATCHER RD, SUITE 202, PHOENIX, AZ 85021-3594
(602) 404-1555
(602) 867-2435
Mailing address
601 W HATCHER RD, SUITE 202, PHOENIX, AZ 85021-3594
(602) 404-1555
(602) 867-2435
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
BH3998
AZ
251S00000X
Community/Behavioral Health Agency
Primary
AZAHCCCS767709
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
767709
AHCCCS
AZ
Enumeration date
12/13/2006
Last updated
05/15/2012
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