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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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2251S00000XCommunity/Behavioral Health Agency
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
4261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
5261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1619451804
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 : 4527 NORTH 27TH AVENUE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-3702
Country : US
Telephone Number : 602-775-5655
Fax Number :
Authorized Official
Title or Position : VP REVENUE CYCLE MGMT
Name : CINDY GAITHER
Credential :
Telephone Number : 602-248-8886
Provider Enumeration Date : 09/24/2018
Last Update Date : 06/08/2024

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

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