Organization
MAGELLAN HEALTH SERVICES OF ARIZONA, INC.
Active
Other names
Maricopa Clinic 1300 N Central
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRIS ADAIR CARSON MD (CHIEF EXECUTIVE OFFICER)
(602) 797-8333
Entity
Organization
Contact information
Practice address
1300 N CENTRAL AVE, PHOENIX, AZ 85004-1722
(602) 251-0650
Mailing address
4129 EAST VAN BUREN STREET, SUITE 150, PHOENIX, AZ 85008
(800) 564-5465
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
BH2971
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
532095
—
AZ
Enumeration date
03/19/2007
Last updated
10/15/2007
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