Organization
COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLETTE ITAMI (PRESIDENT/CEO)
(602) 309-4210
Entity
Organization
Contact information
Practice address
423 N COUNTRY CLUB DR, SUITE 36, MESA, AZ 85201-5717
(602) 309-4210
(480) 629-5996
Mailing address
10645 N TATUM BLVD, PHOENIX, AZ 85028-3068
(602) 309-4210
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSLG7618
AZ
Other
Enumeration date
03/27/2017
Last updated
03/30/2018
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