Organization
EAGLE HOME
Active
Organization
EAGLE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBI LOPEZ (PROGRAM COORDINATOR)
(520) 721-1887
Entity
Organization
Contact information
Practice address
808 S JERRIE AVE, TUCSON, AZ 85711-4854
(520) 406-2978
Mailing address
994 S HARRISON RD, TUCSON, AZ 85748-6608
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
BH4795
AZ
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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