Organization
COMMUNITY MEDICAL SERVICES IV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEELY TORRES (QUALITY IMPROVEMENT)
(602) 248-8886
Entity
Organization
Contact information
Practice address
3050 N NAVAJO DR, PRESCOTT VALLEY, AZ 86314-8663
(928) 775-7088
(928) 775-7099
Mailing address
3825 N 24TH ST, PHOENIX, AZ 85016-6512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BH-2862
AZ
Other
Enumeration date
06/23/2009
Last updated
06/23/2009
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