Chicanos Por la Causa, Inc.
Organization Active NPI Community/Behavioral Health Agency · Claypool, AZ
NPI 1679757553 · NPPES record last updated Mar 17, 2011
Key facts
- NPI
- 1679757553
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- BH-2823 (AZ)
- Legal business name
- CHICANOS POR LA CAUSA, INC.
- Practice address
- 4443 E. Broadway
Claypool, AZ 85532 - Phone
- (928) 425-9244
- Fax
- (928) 425-9249
- NPI assigned
- Dec 27, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- CHICANOS POR LA CAUSA, INC.
Authorized official
- Name
- Mr. Edmundo Hidalgo
- Title
- Ceo
- Phone
- (602) 257-0700
Other NPIs on the same Medicare enrollment 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050305000056 | AZ | Part B Supplier - Clinic/Group Practice | 4587618285 |
Receives reassigned benefits from 3 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mesa, AZ; Phoenix, AZ |
National Provider Directory
- Part of
- Chicanod Por la Causa
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | BH-2823 | AZ | Yes |
Addresses
Primary practice location
4443 E. Broadway
Claypool, AZ 85532
Mailing address
1112 E. Buckeye Rd.
Phoenix, AZ 85034
Phone (602) 257-0700
Other names
- Centro le la Familia-Globe
Other providers in Claypool, AZ
- Jared Labuda
- New Destiny Healing Arts Center
- Rocky Mountain Holdings LLC
- Tri City Fire District/Ambulance
- Walmart Inc.
All providers in Claypool, AZ · Community/Behavioral Health Agency in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.