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NPI Code Detail

MEDICARE: COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC

MEDICARE: COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QM2800XMethadone Clinic
4261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
5101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1528777430
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC
Provider Business Mailing Address
First Line : 8444 N 90TH ST STE 100
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4437
Country : US
Telephone Number : 480-494-2497
Fax Number : 480-687-7361
Provider Business Practice Location Address
First Line : 7830 N 23RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-6808
Country : US
Telephone Number : 602-775-5634
Fax Number : 602-237-5497
Authorized Official
Title or Position : VP OF REVENUE CYCLE MANAGEMENT
Name : CINDY GAITHER
Credential :
Telephone Number : 602-248-8886
Provider Enumeration Date : 11/18/2022
Last Update Date : 02/10/2024

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Directions to “COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC ” Practice Location

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