Provider Demographics
NPI:1962730309
Name:ARIZONA'S CHILDREN ASSOCIATION
Entity type:Organization
Organization Name:ARIZONA'S CHILDREN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:602-234-3733
Mailing Address - Street 1:3716 E COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-3414
Mailing Address - Country:US
Mailing Address - Phone:602-234-3733
Mailing Address - Fax:602-234-1252
Practice Address - Street 1:1407 MCCULLOCH BLVD N
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-6513
Practice Address - Country:US
Practice Address - Phone:928-680-4458
Practice Address - Fax:928-680-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTC8671261QM0855X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ479802OtherAHCCCS