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Organization
SEQUEL TSI OF ARIZONA, LLC SIERRA VISTA
Active
Organization
SEQUEL TSI OF ARIZONA, LLC SIERRA VISTA
Active
Parent organization
SEQUELCARE OF ARIZONA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEQUELCARE OF ARIZONA, LLC
Authorized official
CHRIS BANKEN (EXECUTIVE DIRECTOR)
(602) 335-2095
Entity
Organization
Contact information
Practice address
4120 E RAMSEY RD, HEREFORD, AZ 85615-8917
(520) 378-6466
(520) 378-6553
Mailing address
4120 E RAMSEY RD, HEREFORD, AZ 85615-8917
(520) 378-6466
(520) 378-6553
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
12/11/2009
Last updated
12/11/2009
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