Organization
ARIZONA REHAB CAMPUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE WILLIAMS (CLAIMS MGR)
(520) 526-1028
Entity
Organization
Contact information
Practice address
6944 E TANQUE VERDE RD, TUCSON, AZ 85715
(623) 326-1055
Mailing address
6944 E TANQUE VERDE RD, TUCSON, AZ 85715-5308
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH5118
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5118
AZ STATE LICENSE
AZ
Enumeration date
05/11/2017
Last updated
06/14/2019
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