# CASA DE TUCSON

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

## Provider details

- **NPI number:** 1790798924
- **Authorized official:** MS. ANNE N HOWARTH REGISTERED NURSE (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (520) 572-0404

## Contact information

- **Practice address:** 3700 W GAILEY DR, TUCSON, AZ 85741-2017
- **Practice address phone:** (520) 572-0404
- **Practice address fax:** (520) 572-0776
- **Mailing address:** 3700 W GAILEY DR, TUCSON, AZ 85741-2017
- **Mailing address phone:** (520) 572-0404
- **Mailing address fax:** (520) 572-0776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | BH-1941 | AZ | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 57990 | AHCCCS | AZ |