Organization
CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC.
Active
Other names
CODAC 4th Avenue
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W MARK CLARK (CEO)
(520) 327-4505
Entity
Organization
Contact information
Practice address
721 N 4TH AVE, TUCSON, AZ 85705-8446
(520) 327-4505
(520) 202-1889
Mailing address
127 S 5TH AVE, TUCSON, AZ 85701-2005
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255732
—
AZ
01
—
BH-2954
ADHS
AZ
Enumeration date
07/20/2007
Last updated
02/15/2008
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