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NPI Code Detail

MEDICARE: COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.

MEDICARE: COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.
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 AgencyCSGL8299AZ
2261Q00000XClinic/Center
3261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2OTC9298OTHERAZBMFL LICENSE

General Provider Information

NPI Number : 1558898635
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.
Provider Business Mailing Address
First Line : PO BOX 86537
Second Line :
City : TUCSON
State : AZ
Zip : 85754-6537
Country : US
Telephone Number : 820-721-1887
Fax Number : 520-721-0069
Provider Business Practice Location Address
First Line : 5055 E BROADWAY BLVD STE A200
Second Line :
City : TUCSON
State : AZ
Zip : 85711-3649
Country : US
Telephone Number : 520-901-4800
Fax Number : 520-901-4700
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : ROSE MARY LOPEZ
Credential : MBA
Telephone Number : 520-721-1887
Provider Enumeration Date : 05/19/2017
Last Update Date : 05/25/2021

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Directions to “COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC. ” Practice Location

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