Organization
SUPPORTED LIVING SYSTEMS
Active
Other names
Saguaro House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ECK PHD (CEO)
(520) 514-9888
Entity
Organization
Contact information
Practice address
5120 E ALBERTA DR, TUCSON, AZ 85711-3119
(520) 514-7840
Mailing address
925 S CRAYCROFT RD, TUCSON, AZ 85711-7112
(520) 514-9888
(520) 514-9878
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH-1883
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593493
AHCCS PROVIDER #
AZ
01
—
BH-1883
AZ BEHAVIORAL LICENSE #
AZ
Enumeration date
01/09/2007
Last updated
08/22/2020
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