Provider Demographics
NPI:1225901267
Name:CATHOLIC COMMUNITY SERVICES - SIERRA VISTA
Entity type:Organization
Organization Name:CATHOLIC COMMUNITY SERVICES - SIERRA VISTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:520-975-5920
Mailing Address - Street 1:268 W ADAMS ST.
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-6534
Mailing Address - Country:US
Mailing Address - Phone:520-623-0344
Mailing Address - Fax:520-770-8578
Practice Address - Street 1:6049 E HWY 90
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-9194
Practice Address - Country:US
Practice Address - Phone:520-459-1285
Practice Address - Fax:520-770-8578
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC COMMUNITY SERVICES OF SOUTHERN ARIZONA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health