Organization
CASA DE TUCSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNE N HOWARTH R.N. (OWNER/ ADMINISTRATOR)
(520) 572-0404
Entity
Organization
Contact information
Practice address
5055 W PIMA FARMS RD, TUCSON, AZ 85741-4736
(520) 572-0404
Mailing address
3700 W GAILEY DR, TUCSON, AZ 85741-2017
(520) 572-0404
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-3098
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH-3098
DEPT OF HEALTH SERVICES LICENSE
AZ
Enumeration date
11/04/2009
Last updated
11/04/2009
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