Organization
CODAC HEALTH, RECOVERY & WELLNESS, INC.
Active
Other names
CODAC Cobblestone Court
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS REGNIER (CEO)
(520) 327-4505
Entity
Organization
Contact information
Practice address
1075 E FORT LOWELL RD, TUCSON, AZ 85719-2159
(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
OTC
AZ
261QP2300X
Primary Care Clinic/Center
OTC
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025936
—
AZ
Enumeration date
12/23/2014
Last updated
09/25/2015
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