Organization
VILLA MARIA CARE CENTER, LLC
Active
Other names
Tucson Recovery Villa Maria
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY MCNELLIS (OWNER)
(612) 991-9062
Entity
Organization
Contact information
Practice address
4310 E GRANT RD STE A, TUCSON, AZ 85712-2607
(520) 323-9351
(520) 323-6490
Mailing address
4310 E GRANT RD, TUCSON, AZ 85712-2607
(520) 323-9351
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH5309
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5309
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
03/28/2018
Last updated
09/28/2020
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