Organization
CATHOLIC CHARITIES COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LANG (RESOURCE SUPPORT SPECIALIST)
(928) 864-7371
Entity
Organization
Contact information
Practice address
434 W GURLEY ST, PRESCOTT, AZ 86301-3616
(928) 778-2531
(928) 771-9531
Mailing address
5151 N 19TH AVE, PHOENIX, AZ 85015-3224
(480) 250-9157
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3155
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
791924
AHCCCS 2013
AZ
Enumeration date
12/26/2012
Last updated
07/14/2023
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