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Organization

PINAL HISPANIC COUNCIL INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSE LOPEZ (CHIEF EXECUTIVE OFFICER)
(520) 721-1887
Entity
Organization

Contact information

Practice address
556 S ARIZONA BLVD, COOLIDGE, AZ 85128-5106
(520) 466-7765
(520) 466-4475
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
BH-889
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
164567
AHCCCS
AZ
01
OTC6003
ADHS/BMFL LICENSE
AZ
Enumeration date
09/20/2006
Last updated
07/25/2025
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