NPIMap

Organization Active NPI

Community Partners Integrated Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Safford, AZ
National Provider Identifier
1619279155
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC8052 Issued in AZ
Legal business name
COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.
Practice address
301 E 4TH St
Ste. a & B
Safford, AZ 85546-2074
Phone
(928) 792-4242
Fax
(928) 428-3885
NPI assigned
Dec 2, 2010
Last updated
Apr 20, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY PARTNERS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Rose Mary Lopez, MBA
Title
President and Ceo
Phone
(520) 721-1887

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Community/Behavioral Health Agency 251S00000X OTC8052 AZ Primary

Addresses

Primary practice location

301 E 4TH St
Ste. a & B
Safford, AZ 85546-2074

Mailing address

PO Box 86537
Tucson, AZ 85754-6537
Phone (520) 721-1887

Other identifiers 2

IdentifierTypeStateIssuer
OTC8052OtherAZBUREAU OF MEDCIAL FACILITIES LICENSING
232459MedicaidAZ

Other names 2

  • Arizona Counseling & Treatment Services Former legal business name
  • Assurance Health and Wellness Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140716002626 AZ Part B Supplier - Clinic/Group Practice 7315163938 Receives reassigned benefits from 48 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benson, AZ; Phoenix, AZ; Safford, AZ; Sierra Vista, AZ; Tucson, AZ; Yuma, AZ

Other NPIs on the same Medicare enrollment 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2187607Community Partners Integrated Healthcare301 E 4TH Street Suite a-B, Safford, AZ 85546Certificate of waiverJul 5, 2028

National Provider Directory

National Provider Directory
Tax ID family
Community Partners7 organizations share this tax ID, including this one
Part of
Community Partners Inc

Other organizations with this tax ID 6

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1619279155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86537",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857546537",
            "telephone_number": "520-721-1887",
            "fax_number": "520-721-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 4TH ST",
            "address_2": "STE. A & B",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855462074",
            "telephone_number": "928-792-4242",
            "fax_number": "928-428-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY PARTNERS INC.",
        "enumeration_date": "2010-12-02",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "520-721-1887",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC8052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF MEDCIAL FACILITIES LICENSING",
            "identifier": "OTC8052",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "232459",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Counseling & Treatment Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Assurance Health and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Assurance Health and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Safford, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.