Organization
PANTANO BEHAVIORAL HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA S ARENDT CFE (DIRECTOR OF FINANCE)
(520) 623-9833
Entity
Organization
Contact information
Practice address
5055 E BROADWAY BLVD STE C104, TUCSON, AZ 85711-3641
(520) 623-9833
(520) 623-9083
Mailing address
5055 E BROADWAY BLVD STE C104, TUCSON, AZ 85711-3641
(520) 623-9833
(520) 623-9083
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
BH-2183
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
772576
AHCCCS ID
AZ
Enumeration date
08/01/2006
Last updated
11/14/2012
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