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COMMUNITY INTERVENTION ASSOCIATES INC. NPI 1255663423


NPI Information

NPI: 1255663423
Provider Name: COMMUNITY INTERVENTION ASSOCIATES, INC.

Doing Business As: COMMUNITY INTERVENTION ASSOCIATES

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 03D2178842

Address:
1516 OCOTILLO AVENUE
PARKER, AZ
ZIP 85344
Phone: (928) 669-5319
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COMMUNITY INTERVENTION ASSOCIATES, INC. is a community behavioral health in Parker, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. COMMUNITY INTERVENTION ASSOCIATES, INC. NPI is 1255663423. The provider is registered as an organization entity type.
The provider Is Doing Business As Community Intervention Associates.

The provider's business location address is:

1516 OCOTILLO AVENUE
PARKER, AZ
ZIP 85344-000
Phone: (928) 669-5319
Fax: (928) 669-5368

The provider's authorized official is Fred R Cogburn .
The authorized official title is Ceo and has the following contact phone number (928) 376-0026.

The CLIA number assigned to this NPI record is 03D2178842 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/12/2010 and was last updated on 8/28/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthBH3488ARIZONANo
2251S00000XCommunity/Behavioral HealthBH-3994ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1Z153915MEDICARE UPINARIZONA
2750372MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.