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Organization
DESERT MILAGROS, LLC
Active
Organization
DESERT MILAGROS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH VALENTINA SUASO PH.D. (EXECUTIVE DIRECTOR)
(520) 531-1040
Entity
Organization
Contact information
Practice address
3438 N. COUNTRY CLUB ROAD, TUCSON, AZ 85716-1257
(520) 531-1040
(520) 325-1040
Mailing address
3438 N. COUNTRY CLUB ROAD, TUCSON, AZ 85716-1257
(520) 531-1040
(520) 325-1040
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
OTC6580
AZ
261QM0850X
Adult Mental Health Clinic/Center
BH3142
AZ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
BH3142
AZ
Other
Enumeration date
01/09/2010
Last updated
06/11/2015
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