Organization
NATIVE MIND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CACHORA RENA STANDIFER MRT (CHIEF EXECUTIVE OFFICER)
(520) 289-1838
Entity
Organization
Contact information
Practice address
6294 S EAGLE TALON PKWY, TUCSON, AZ 85757
(520) 289-1838
Mailing address
PO BOX 2711, SELLS, AZ 85634-2711
(520) 289-1838
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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