PROVIDENCE OF ARIZONA, INC. (NPI# 1588764427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588764427 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE OF ARIZONA, INC. |
| Other Organization Name | PROVIDENCIA |
| Practice Address |
3602 W Thomas Rd Phoenix AZ 85019-4442 |
| Mailing Address |
620 N Craycroft Rd Tucson AZ 85711-1448 |
| Practice Telephone | 6024554626 |
| Practice Fax Number | 6024554624 |
| Mailing Telephone | 5207476676 |
| Mailing Fax Number | 5207476605 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID HEDGCOCK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6024554626 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
BH-2200 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 796021 | 05 |
| Other Name | Type Code |
|---|---|
| Providencia | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003136748 | Providence of Arizona, Inc. | Clinic/Center | 630 N Craycroft Rd, Tucson, AZ 85711-1440 | 2010-06-04 |
| Street Address |
3602 W THOMAS RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85019-4442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964488 | Roger Beck Slice | Registered Nurse | 6331 N. 39th Ave., Phoenix, AZ 85019 | 2018-12-20 |
| 1093204687 | Patricia Enevy Gomez Jayme | Physical Therapist | 532 W Thomas Rd Suite 5, Phoenix, AZ 85019 | 2018-05-09 |
| 1396257762 | Shirley Ann Furlong | Licensed Practical Nurse | Alhambra School District No 68, 4510 N 37th Avenue, Phoenix, AZ 85019 | 2017-10-25 |
| 1508253014 | Benjamin Noel Zuniga | Dentist | 3542 W Camelback Rd, Phoenix, AZ 85019 | 2015-04-22 |
| 1063610475 | German Dobson Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | Thomas & 43rd Ave, Phoenix, AZ 85019 | 2007-07-06 |
| 1558489575 | Beverly Beierbach Wells | Speech-Language Pathologist | 3839 W Camelback Road, Phoenix, AZ 85019 | 2007-03-27 |
| 1497872600 | Josefa Almanza | Speech-Language Pathologist | 4006 W Osborn Rd, Phoenix, AZ 85019 | 2007-03-23 |
| 1760550024 | Steven C Chang | Dentist | 3608 W Camelback Rd, Phoenix, AZ 85019 | 2006-12-02 |
| 1891723623 | George Figueroa | Obstetrics & Gynecology | 3660 W. Bethany Home Road, Suite A, Phoenix, AZ 85019 | 2006-06-29 |
| 1881169704 | Janice Jinju Kim | Dentist | 3608 W Camelback Rd, Phoenix, AZ 85019 | 2018-10-07 |
| Find all providers in zip 85019 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1982163549 | Amore Aware LLC | Clinic/Center | 6900 E Princess Dr Unit 1214, Phoenix, AZ 85054-4110 | 2019-03-13 |
| 1356805816 | Arizonas New Hope | Clinic/Center | 10000 N 31st Ave Ste D304g, Phoenix, AZ 85051-9582 | 2019-01-29 |
| 1306331509 | Native American Connections | Clinic/Center | 4520 N Central Ave Ste 380, Phoenix, AZ 85012-7815 | 2018-06-29 |
| 1194135152 | Connectionsaz, LLC | Clinic/Center | 1201 S 7th Ave Ste 150, Phoenix, AZ 85007-4075 | 2014-04-30 |
| 1770888646 | Southwest Behavioral Health Services, Inc. | Clinic/Center | 1601 W Desert Cove Ave, Phoenix, AZ 85029-5023 | 2011-01-24 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.