ARIZONA HEALTH CARE CONTRACT MANAGEMENT SERVICES INC. NPI 1407026644

NPI Information

NPI: 1407026644
Provider Name: ARIZONA HEALTH CARE CONTRACT MANAGEMENT SERVICES INC.

Doing Business As: SIX PINES

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
5344 N 40TH LN
PHOENIX, AZ
ZIP 85019
Phone: (602) 249-4758
Get Directions

ARIZONA HEALTH CARE CONTRACT MANAGEMENT SERVICES INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in Phoenix, AZ. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. ARIZONA HEALTH CARE CONTRACT MANAGEMENT SERVICES INC. NPI is 1407026644. The provider is registered as an organization entity type.
The provider Is Doing Business As Six Pines.

The provider's business location address is:

5344 N 40TH LN
PHOENIX, AZ
ZIP 85019-213
Phone: (602) 249-4758

The provider's authorized official is Jackie Moler .
The authorized official title is Vp, Coo and has the following contact phone number (602) 230-2222.

The enumeration date for this NPI number is 3/4/2008 and was last updated on 3/4/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		BH-1770	ARIZONA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	109844	MEDICAID	ARIZONA

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

NPI Synchronization or Removal

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