DOUGLAS ARC (NPI# 1760589204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760589204 |
Entity Type | Organization |
Organization Name | DOUGLAS ARC |
Practice Address |
610 9th Street Douglas AZ 85607 |
Mailing Address |
Po Box 252 Douglas AZ 85608 |
Practice Telephone | 5203647473 |
Practice Fax Number | 5203642236 |
Mailing Telephone | 5203647473 |
Mailing Fax Number | 5203642236 |
Enumeration Date | 2006-09-19 |
Last Update Date | 2007-08-21 |
Authorized Official Name | MR. GARY J CLARK (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 5203647473 |
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) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | AHCCCS | 704933 | 01 |
AZ | AZ BEHAVIORAL HEALTH SERV | CSA06ADHS0046 | 01 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | DOUGLAS ARC, INC. | 610 9th St, Douglas, AZ 85607-2157 |
Street Address |
610 9TH STREET |
City | DOUGLAS |
State | AZ |
Zip Code | 85607 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811472665 | Chiricahua Community Health Centers, Inc | Clinic/Center | 1151 16th Street, Douglas, AZ 85607 | 2018-09-27 |
1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
1609279108 | Walter Tucker | Counselor | 2100 E 8th, Douglas, AZ 85607 | 2014-09-29 |
1851700488 | Gerardo Grijalva | Non-emergency Medical Transport (VAN) | 2714 E 6th St, Douglas, AZ 85607 | 2014-08-07 |
1174933246 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1019 F Ave, Douglas, AZ 85607 | 2014-04-29 |
1831473164 | Cheryl Lynn Mcneeley | Speech-Language Pathologist | 815 E. 15th Street, Douglas, AZ 85607 | 2011-10-05 |
1245523364 | Community Intervention Associates | Community/Behavioral Health | 1701 North Douglasave, Douglas, AZ 85607 | 2011-05-23 |
1174820898 | Chiricahua Community Health Centers, Inc | Clinic/Center | 815 15th Street, Douglas, AZ 85607 | 2011-02-15 |
1033319512 | Community Healthcare of Douglas Inc | Clinic/Center | 1906 11th Street, Douglas, AZ 85607 | 2007-07-23 |
1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
Find all providers in zip 85607 |
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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---|---|---|---|---|
1225003023 | Solutions for Life | Clinic/Center | 1841 Madora Ave, Douglas, WY 82633-3057 | 2006-02-23 |
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Find all providers with the same taxonomy |
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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.