Gila River Indian Community Department of Human Services

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GILA RIVER INDIAN COMMUNITY DEPARTMENT OF HUMAN SERVICES

Practice address

3850 N. 16 Street
Laveen, AZ 85339

Phone

(520) 796-3860

Fax

(520) 796-3801

NPI assigned

Apr 6, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Glenn Thomas Cummings, MA, LISAC, LPC

Title

Director

Phone

(520) 796-3802

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Gila River Indian Community Department of Human Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Gila River Indian Community Department of Human Services

  • Community/Behavioral Health Agency
  • Sacaton, AZ
  • NPI 1700060878
  NPD tax ID

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1073755013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853390602",
            "telephone_number": "520-796-3860",
            "fax_number": "520-796-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 N. 16 STREET",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "85339",
            "telephone_number": "520-796-3860",
            "fax_number": "520-796-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILA RIVER INDIAN COMMUNITY DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "520-796-3802",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LISAC, LPC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA HEALTH CARE COST CONTAINMENT  SYSTEM",
            "identifier": "074165",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM",
            "identifier": "411673",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gila River Health Care Corporation
• Gila River Health Care Corporation
• Gila River Health Care Corporation
• Gila River Health Care Corporation
• Gila River Health Care Corporation
• Ginaped Health Care Services
• Global Health Az
• Global Learning Academic Center, LLC
• Selene Veronica Gonzalez
• Good Health Medical, PLLC

• All providers in Laveen, AZ
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.