Organization
BEHAVIORAL CONSULTATION SERVICES, INC.
Active
Parent organization
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT
Authorized official
ROSE MARY LOPEZ MBA (PRESIDENT AND CEO)
(520) 721-1887
Entity
Organization
Contact information
Practice address
1515 E CEDAR AVE STE A-6, FLAGSTAFF, AZ 86004-1630
(800) 771-9889
(928) 563-0048
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
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146544
—
AZ
01
—
BH6642
BUREAU OF MEDICAL FACILITIES LICENSING
AZ
01
—
OTC7929
ADHS/BMFL LICENSE
AZ
Enumeration date
04/08/2016
Last updated
01/25/2021
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