Arizona Department of Health Services
Health and Wellness for All Arizonans
ADHS Home Page
|
A-Z Index
|
Licensing Services
|
Search
|
Contact ADHS
Medical Facilities Report
This report is published by the Arizona Department of Health Services (ADHS) Division of Licensing Services. For assistance, please contact the Bureau of Medical Facilities at Phone (602) 364-3030; Fax (602) 364-4764.
Provider Type Info
Name:
15TH STREET PEDIATRIC CENTER OF EXCELLENCE
Address:
815 15TH STREET DOUGLAS, AZ 85607
Phone:
(520) 364-1429
Fax:
(520) 364-2998
Facility ID:
MED4512
License Effective:
5/1/2024
License Expires:
4/30/2025
Status:
ACTIVE
Licensee:
CHIRICAHUA COMMUNITY HEALTH CENTERS, INC.
License:
OTC5111
Provider Type:
OUTPATIENT TREATMENT CENTER
Services
Effective Date
Service
5/15/2019
BH SERV UNDER 18 YR OLDS
No Surveys for this Provider
No Enforcement Actions for this Provider.