# INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Intermountain Centers
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861042012
- **Authorized official:** ROSE MARY LOPEZ MBA (PRESIDENT AND CEO)
- **Authorized official phone:** (520) 721-1887

## Contact information

- **Practice address:** 401 N BONITA AVE, TUCSON, AZ 85709-5001
- **Practice address phone:** (520) 571-6466
- **Practice address fax:** (520) 721-0069
- **Mailing address:** PO BOX 86537, TUCSON, AZ 85754-6537
- **Mailing address phone:** (520) 721-1887
- **Mailing address fax:** (520) 721-0069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/18/2019
- **Last updated:** 04/29/2020