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General NPI Number Information
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NPI Number | 1255663423
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Entity Type | Organization
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Legal Business Name | COMMUNITY INTERVENTION ASSOCIATES, INC.
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 1516 S OCOTILLO AVE
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City | PARKER
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State | AZ
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Zip | 85344-6234
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Country | US
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Telephone | 928-669-5319
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Fax | 928-669-5368
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Provider Business Mailing Address
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Address Line | 2851 S AVENUE B BLDG 4
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City | YUMA
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State | AZ
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Zip | 85364-7726
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Country | US
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Telephone | 928-376-0026
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Fax | 928-782-2298
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Authorized Official
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Title or Position | DIRECTOR OF LOGISTICS
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Name | MR. ALLISON S NICOL
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Credential |
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Telephone | 520-988-0811
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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 | BH3488
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH-3994
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License Number State | AZ
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