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Individual

LUIS APODACA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6251 E 25TH ST, TUCSON, AZ 85711-6014
(520) 481-9441
(520) 296-8244
Mailing address
6251 E 25TH ST, TUCSON, AZ 85711-6014
(520) 481-9441
(520) 296-8244

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
BH4915
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BH4915
AZ DHS LICENSE
AZ
Enumeration date
06/17/2016
Last updated
06/17/2016
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