N/A
LBN: Ccr Intergrated Health
N/A is an health care organization with primary practice located at 12268 W Delwood Drive 3699, Arizona City AZ 85123. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Psychiatric Residential Treatment Facility. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness is the primary health care specialty.
Ccr Intergrated Health can be contacted via phone (228) 383-1240, or through Burton, Clarence Vanard via phone (228) 383-1240.
Contact Information
Primary practice address
12268 W Delwood Drive 3699
Arizona City AZ 85123
Phone: (228) 383-1240
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | Arizona | |
| Residential Treatment Facilities / Psychiatric Residential Treatment Facility | 323P00000X | Arizona |
Profile Details
| NPI number | 1073908810 |
|---|---|
| LBN Legal business name | Ccr Intergrated Health |
| DBA Doing business as | N/A |
| Authorized official | Burton, Clarence Vanard |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 30th, 2015 |
| Last updated | Mar 30th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073908810 | NPPES |
| Arizona | MEDICAID | 503218 |
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