Organization
MARANA TEEN WELLNESS CENTER
Active
Organization
MARANA TEEN WELLNESS CENTER
Active
Parent organization
MARANA HEALTH CENTER, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARANA HEALTH CENTER, INC
Authorized official
DD SANDE (CREDENTIALING SPECIALIST)
(520) 682-4560
Entity
Organization
Contact information
Practice address
13644 N SANDARIO RD, MARANA, AZ 85653-8579
(520) 682-4730
(520) 682-4790
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4560
(520) 682-4570
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
OTC 0820
AZ
Other
Enumeration date
04/29/2010
Last updated
04/29/2010
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