Healthcare Provider Details

I. General information

NPI: 1891965703
Provider Name (Legal Business Name): COPE COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 08/09/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W COMMERCE CT
TUCSON AZ
85746-6016
US

IV. Provider business mailing address

1477 W COMMERCE CT
TUCSON AZ
85746-6016
US

V. Phone/Fax

Practice location:
  • Phone: 520-741-3180
  • Fax:
Mailing address:
  • Phone: 520-792-3293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberOTC6074
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License NumberOT6074
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberOTC6074
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOTC6074
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberOTC6074
License Number StateAZ

VIII. Authorized Official

Name: RODNEY COOK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 520-792-3293