Organization
PINAL HISPANIC COUNCIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE M LOPEZ MBA (PRESIDENT AND CEO)
(520) 721-1887
Entity
Organization
Contact information
Practice address
1940 E 11TH ST, DOUGLAS, AZ 85607-2413
(520) 466-7765
(520) 466-4475
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 721-0069
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH3766
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
598482
—
AZ
01
—
BH3766
OBHL LICENSE
AZ
01
—
OTC6065
ADHS/BMFL LICENSE
AZ
Enumeration date
11/19/2010
Last updated
10/27/2025
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