Provider Demographics
NPI:1730428517
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
Mailing Address - Country:US
Mailing Address - Phone:602-234-3733
Mailing Address - Fax:602-234-1252
Practice Address - Street 1:4524 N MARYVALE PKWY
Practice Address - Street 2:SUITES 220, 260 & 280
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031
Practice Address - Country:US
Practice Address - Phone:623-414-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0855X
AZOTC6159261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ798739Medicaid