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Organization

GILA RIVER INDIAN COMMUNITY DEPARTMENT OF HUMAN SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GLENN THOMAS CUMMINGS M.A. (ACTING DIRECTOR)
(520) 562-3356
Entity
Organization

Contact information

Practice address
315 W. CASA BLANCA RD, SACATON, AZ 85247-2171
(520) 562-3356
Mailing address
PO BOX 2171, SACATON, AZ 85247-2171
(520) 562-3356

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
074165
AHCCCS
AZ
Enumeration date
12/24/2007
Last updated
12/24/2007
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