| Community Intervention Associagtes | |
|
3802 W 16th St Yuma AZ 85364-4107 | |
| (928) 376-0026 | |
| (928) 782-2298 |
| Full Name | Community Intervention Associagtes |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3802 W 16th St, Yuma, Arizona |
| Authorized Official Name and Position | Gustavo Albert Rodriguez (CLINICAL LIAISON) |
| Authorized Official Contact | 9283760026 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Intervention Associagtes 3802 W 16th St Yuma AZ 85364-4107 Ph: (928) 376-0026 | Community Intervention Associagtes 3802 W 16th St Yuma AZ 85364-4107 Ph: (928) 376-0026 |
| NPI Number | 1144382524 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144382524 | NPI | - | NPPES |
| 913922 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LISAC-1257 (Arizona) | Primary |
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