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General NPI Number Information
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NPI Number | 1285447060
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Entity Type | Organization
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Legal Business Name | LUCA COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 21259 E OCOTILLO RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-9339
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Country | US
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Telephone | 480-582-4604
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Fax |
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Provider Business Mailing Address
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Address Line | 382 W STANLEY AVE
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City | QUEEN CREEK
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State | AZ
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Zip | 85140-6669
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Country | US
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Telephone | 480-582-4604
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | CRYSTAL RANE BROWN
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Credential | LAC
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Telephone | 480-582-4604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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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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