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NPI 1235271404

NPI 1235271404 : PINAL HISPANIC COUNCIL : ELOY, AZ

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General NPI Number Information
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    NPI Number           |    1235271404
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    Entity Type          |    Organization 
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    Legal Business Name  |    PINAL HISPANIC COUNCIL 
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Dates
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    Enumeration Date     |    02/13/2007
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    Last Update Date     |    10/27/2025
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Provider Practice Location Address
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    Address Line         |    107 EAST 4TH STREET 
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    City                 |    ELOY
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    State                |    AZ
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    Zip                  |    85131-2500
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    Country              |    US
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    Telephone            |    520-466-7765
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    Fax                  |    520-466-4475
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Provider Business Mailing Address
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    Address Line         |    PO BOX 86537 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85754-6537
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    Country              |    US
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    Telephone            |    520-721-1887
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    Fax                  |    520-721-0069
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Authorized Official
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    Title or Position    |    PRESIDENT AND CEO
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    Name                 |     ROSE M LOPEZ 
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    Credential           |    MBA
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    Telephone            |    520-721-1887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    BH-3952
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    License Number State |    AZ
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Taxonomy #2
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    Taxonomy Code        |    261QM1300X
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    Taxonomy Name        |    Multi-Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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