Provider Demographics
NPI:1881753184
Name:FOR THE COMMUNITY SERVICES
Entity type:Organization
Organization Name:FOR THE COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNTBAUSE
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:BS
Authorized Official - Phone:602-249-2996
Mailing Address - Street 1:5124 N 19TH AVE
Mailing Address - Street 2:SUITE #250
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3233
Mailing Address - Country:US
Mailing Address - Phone:602-249-2996
Mailing Address - Fax:602-242-3405
Practice Address - Street 1:5124 N 19TH AVE
Practice Address - Street 2:SUITE #250
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3233
Practice Address - Country:US
Practice Address - Phone:602-249-2996
Practice Address - Fax:602-242-3405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH3118251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health