Organization
CODAC HEALTH, RECOVERY & WELLNESS, INC.
Active
Other names
CODAC at Desert Life
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS REGNIER (CEO)
(520) 327-4505
Entity
Organization
Contact information
Practice address
2001 W ORANGE GROVE RD, STE 416, TUCSON, AZ 85704-1139
(520) 327-4505
(520) 202-1889
Mailing address
1650 E FORT LOWELL RD, STE 202, TUCSON, AZ 85719-2374
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
CSLG7120
AZ
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025747
—
AZ
Enumeration date
11/26/2013
Last updated
09/25/2015
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