Organization
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC.
Active
Organization
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC.
Active
Other names
Nogales
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE LOPEZ MBA (CEO)
(520) 721-1887
Entity
Organization
Contact information
Practice address
276 WEST VIEW POINT DRIVE, NOGALES, AZ 85621
(520) 281-0678
(520) 281-0772
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 721-0069
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OTC7773
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185236
—
AZ
01
—
OTC7773
ADHS/BMFL LICENSE
AZ
Enumeration date
09/02/2016
Last updated
10/09/2020
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