Healthcare Provider Details

I. General information

NPI: 1992691398
Provider Name (Legal Business Name): CALVARY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E MONTEBELLO AVE
PHOENIX AZ
85014-2543
US

IV. Provider business mailing address

720 E MONTEBELLO AVE
PHOENIX AZ
85014-2543
US

V. Phone/Fax

Practice location:
  • Phone: 602-279-3090
  • Fax:
Mailing address:
  • Phone: 602-279-3090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL D MCFARLAND
Title or Position: CEO
Credential: LMSW
Phone: 602-279-1468