Organization
CHA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE LEON BA (CEO)
(520) 622-8357
Entity
Organization
Contact information
Practice address
1773 W SAINT MARYS RD, TUCSON, AZ 85745-2654
(520) 833-1898
Mailing address
1773 W SAINT MARYS RD, TUCSON, AZ 85745-2654
(520) 883-8898
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LISAC 1463
AZ
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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