Healthcare Provider Details

I. General information

NPI: 1730547134
Provider Name (Legal Business Name): COPE COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 W COMMERCE POINT PL
GREEN VALLEY AZ
85614
US

IV. Provider business mailing address

1477 W COMMERCE CT
TUCSON AZ
85746-6016
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-3293
  • Fax: 520-792-4336
Mailing address:
  • Phone: 520-792-3293
  • Fax: 520-792-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberOTC7477
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOTC7477
License Number StateAZ
# 8
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberOTC7477
License Number StateAZ
# 9
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberOTC7477
License Number StateAZ

VIII. Authorized Official

Name: MR. RODNEY COOK
Title or Position: CEO
Credential:
Phone: 520-792-3293