Organization
COMMUNITY INTERVENTION ASSOCIATES
Active
Other names
Community Health Associates
Organization subpart
No
Provider details
NPI number
Authorized official
FRED COGBURN (CEO)
(928) 376-0026
Entity
Organization
Contact information
Practice address
1923 NORTH TREKELL ROAD, CASA GRANDE, AZ 85122
(928) 376-0026
(520) 836-5436
Mailing address
2851 S AVE B, BLDG 4, YUMA, AZ 85364
(928) 376-0026
(928) 782-2298
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OTC-6458
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014619
—
AZ
Enumeration date
01/05/2015
Last updated
02/03/2016
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