Provider Demographics
NPI:1013705458
Name:ARIZONA COMMUNITY SUPPORT SERVICES INC
Entity type:Organization
Organization Name:ARIZONA COMMUNITY SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-891-2611
Mailing Address - Street 1:4934 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3612
Mailing Address - Country:US
Mailing Address - Phone:520-891-2611
Mailing Address - Fax:
Practice Address - Street 1:5142 S FOX TROT DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-1171
Practice Address - Country:US
Practice Address - Phone:520-891-2611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness