Organization
MAGELLAN HEALTH SERVICES OF ARIZONA, INC.
Active
Other names
Maricopa Clinic Centro Esperanza
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRIS ADAIR CARSON MD (CHIEF EXECUTIVE OFFICER)
(602) 797-8333
Entity
Organization
Contact information
Practice address
310 S EXTENSION RD, MESA, AZ 85210-1292
(480) 615-3800
Mailing address
4129 EAST VAN BUREN STREET, SUITE 150, PHOENIX, AZ 85008
(800) 654-5465
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
BH2964
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805426
—
AZ
Enumeration date
03/20/2007
Last updated
10/15/2007
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