Healthcare Provider Details

I. General information

NPI: 1144420449
Provider Name (Legal Business Name): CATHOLIC COMMUNITY SERVICES OF SOUTHERN ARIZONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
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: 520-623-0344
  • Fax: 520-770-8578
Mailing address:
  • Phone: 520-623-0344
  • Fax: 520-770-8578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: ELENA DWYRE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSW, DSW
Phone: 520-623-0344