Organization
CASA DE LOS NINOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSIE DYER (NURSE SUPERVISOR)
(520) 624-5600
Entity
Organization
Contact information
Practice address
1101 N. 4TH AVE, TUCSON, AZ 85705
(520) 624-5600
Mailing address
1145 N. 4TH AVE., TUCSON, AZ 85705
(520) 624-5600
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
385189
AHCCCS
AZ
Enumeration date
05/11/2007
Last updated
08/22/2020
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