Chicanos Por la Causa, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH-0008 Issued in AZ

Legal business name

CHICANOS POR LA CAUSA, INC.

Practice address

3639 W. Lincoln St.
Phoenix, AZ 85009

Phone

(602) 233-9747

Fax

(602) 352-5989

NPI assigned

Sep 20, 2006

Last updated

Jun 23, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

CHICANOS POR LA CAUSA INC.As reported in NPPES

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

Authorized official

Name

Mr. Andres Contreras

Title

Executive Vice President Officer

Phone

(602) 257-0700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Corazon Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Chicanos Por la Causa Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1255416103

  O20050305000056

  Same enrollment
• Chicanos Por la Causa, Inc

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1487024543

  O20050305000056

  Same enrollment
• Chicanos Por la Causa, Inc.

  • Community/Behavioral Health Agency
  • Claypool, AZ
  • NPI 1679757553

  O20050305000056

  Same enrollment
• Chicanos Por la Causa, Inc.

  • Community/Behavioral Health Agency
  • Yuma, AZ
  • NPI 1922280742

  O20050305000056

  Same enrollment

Part of

Chicanos Por la Causa Inc

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1083711360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 E. BUCKEYE RD.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85034",
            "telephone_number": "602-257-0700",
            "fax_number": "602-307-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 W. LINCOLN ST.",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85009",
            "telephone_number": "602-233-9747",
            "fax_number": "602-352-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICANOS POR LA CAUSA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHICANOS POR LA CAUSA INC.",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "CONTRERAS",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT OFFICER",
        "authorized_official_telephone_number": "602-257-0700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-0008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590978",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "BH-0008",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corazon",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Corazon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patrick Darin Chiavaroli, D.C.
• Chicanod Por la Causa
• Chicanos Por la Causa
• Chicanos Por la Causa Inc
• Chicanos Por la Causa Inc
• Chicanos Por la Causa, Inc.
• Chicanos Por la Causa, Inc.
• Chicanos Por la Causa, Inc.
• Chicanos Por la Causa, Inc. (Keogh Health Connection)
• Karen Chief-Onesalt, CRT

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.