Provider Demographics
NPI:1346423647
Name:MARICOPA CRISIS RECOVERY NETWORK, INC.
Entity Type:Organization
Organization Name:MARICOPA CRISIS RECOVERY NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATA ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-337-7813
Mailing Address - Street 1:4129 E VAN BUREN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4129 E VAN BUREN ST STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6939
Practice Address - Country:US
Practice Address - Phone:602-337-7813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization