NPIMap

Organization Active NPI

Catholic Charities Community Services, Inc

  • Community/Behavioral Health Agency
  • Prescott, AZ
National Provider Identifier
1053490052
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC5874 Issued in AZ
Legal business name
CATHOLIC CHARITIES COMMUNITY SERVICES, INC
Practice address
434 W Gurley Street
Prescott, AZ 86301
Phone
(928) 778-2531
Fax
(928) 771-9531
NPI assigned
Nov 2, 2006
Last updated
Jul 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Lang
Title
Resource Support Specialist
Phone
(928) 864-7371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH316 AZ
Community/Behavioral Health Agency 251S00000X OTC5874 AZ Primary

Addresses

Primary practice location

434 W Gurley Street
Prescott, AZ 86301

Mailing address

5151 N 19TH Ave
Phoenix, AZ 85015-3224
Phone (480) 250-9157

Other identifiers 1

IdentifierTypeStateIssuer
442265OtherAZAHCCCS

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities Community Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1053490052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153224",
            "telephone_number": "480-250-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 W GURLEY STREET",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-778-2531",
            "fax_number": "928-771-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES COMMUNITY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "RESOURCE SUPPORT SPECIALIST",
        "authorized_official_telephone_number": "928-864-7371",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH316",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC5874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "442265",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.