Organization
COMMUNITY COUNSELING CENTERS, INC
Active
Other names
Winslow Developmental Disabilities
Organization subpart
No
Provider details
NPI number
Authorized official
BETH CARLSON (PROGRAM MANAGER)
(928) 289-3383
Entity
Organization
Contact information
Practice address
1008 E FIRST ST, WINSLOW, AZ 86047-4104
(928) 289-3383
(928) 289-3385
Mailing address
1008 E FIRST ST, WINSLOW, AZ 86047-4104
(928) 289-3383
(928) 289-3385
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108490
—
AZ
Enumeration date
04/05/2011
Last updated
04/05/2011
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