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General NPI Number Information
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NPI Number | 1225162324
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Entity Type | Organization
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Legal Business Name | MAGELLAN HEALTH SERVICES OF ARIZONA, INC.
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 1930 S ALMA SCHOOL RD
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City | MESA
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State | AZ
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Zip | 85210-3064
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Country | US
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Telephone | 602-685-3846
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Fax |
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Provider Business Mailing Address
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Address Line | 4129 EAST VAN BUREN STREET SUITE 150
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City | PHOENIX
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State | AZ
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Zip | 85008
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Country | US
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Telephone | 800-654-5465
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. CHRIS ADAIR CARSON
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Credential | MD
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Telephone | 602-797-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | BH2967
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License Number State | AZ
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