| Catholic Community Services Of So Az Inc | |
|
140 W Speedway Blvd Ste 100 Tucson AZ 85705-7687 | |
| (520) 628-7871 | |
| (520) 205-8461 |
| Full Name | Catholic Community Services Of So Az Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 140 W Speedway Blvd Ste 100, Tucson, Arizona |
| Authorized Official Name and Position | Nancy J Johnson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5206287871 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Community Services Of So Az Inc 140 W Speedway Blvd Ste 100 Tucson AZ 85705-7687 Ph: (520) 628-7871 | Catholic Community Services Of So Az Inc 140 W Speedway Blvd Ste 100 Tucson AZ 85705-7687 Ph: (520) 628-7871 |
| NPI Number | 1932231347 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932231347 | NPI | - | NPPES |
| 961707 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | RN050573 (Arizona) | Primary |
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