Organization
COMMUNITY 43
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA CLINE B.A. (C.E.O.)
(602) 274-4343
Entity
Organization
Contact information
Practice address
4343 N 16TH ST, PHOENIX, AZ 85016-5338
(602) 274-4343
Mailing address
4343 N 16TH ST, PHOENIX, AZ 85016-5338
(602) 274-4343
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/12/2020
Last updated
08/27/2024
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