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Organization
THE GOOD SAMARITAN HOUSE LLC
Active
Organization
THE GOOD SAMARITAN HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACQUELINE LORRAINE LOUISSAINT (VICE PRESIDENT)
(833) 472-6274
Entity
Organization
Contact information
Practice address
6959 S MARTLET DR, TUCSON, AZ 85756-8621
(833) 472-6274
Mailing address
6959 S MARTLET DR, TUCSON, AZ 85756-8621
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Enumeration date
07/19/2022
Last updated
07/19/2022
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