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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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2101YA0400XAddiction (Substance Use Disorder) Counselor
3251S00000XCommunity/Behavioral Health Agency
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
5261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1568947497
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 : 602-248-8886
Fax Number : 602-248-8999
Provider Business Practice Location Address
First Line : 7830 NORTH 23RD AVENUE
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-6808
Country : US
Telephone Number : 602-248-8886
Fax Number : 602-248-8999
Authorized Official
Title or Position : CEO
Name : NICK STAVROS
Credential :
Telephone Number : 602-248-8886
Provider Enumeration Date : 09/26/2018
Last Update Date : 08/21/2025

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