# TINA TONY RESIDENTIAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417269176
- **Authorized official:** MRS. CELESTINA NNEKA ANYAEJI BHT (PROGRAM DIRECTOR)
- **Authorized official phone:** (520) 777-6094

## Contact information

- **Practice address:** 5907 E SANDERLING DR, TUCSON, AZ 85756-8630
- **Practice address phone:** (520) 777-6094
- **Mailing address:** 5907 E SANDERLING DR, TUCSON, AZ 85756-8630
- **Mailing address phone:** (520) 777-6094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | BH3603 | AZ | Yes |

## Other

- **Enumeration date:** 07/10/2010
- **Last updated:** 07/10/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | BH3603 | BEHEVIORAL HEALTH RESIDENTIAL | AZ |