Healthcare Provider Details

I. General information

NPI: 1578763298
Provider Name (Legal Business Name): CATHOLIC COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 W ADAMS ST
TUCSON AZ
85705-6534
US

IV. Provider business mailing address

268 W ADAMS ST
TUCSON AZ
85705-6534
US

V. Phone/Fax

Practice location:
  • Phone: 520-792-1906
  • Fax: 520-770-8544
Mailing address:
  • Phone: 520-792-1906
  • Fax: 520-770-8544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNE LEVY
Title or Position: EXECUTIVE DIRECTOR
Credential: MA
Phone: 520-792-1906