Organization
TINA TONY RESIDENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CELESTINA NNEKA ANYAEJI BHT (PROGRAM DIRECTOR)
(520) 777-6094
Entity
Organization
Contact information
Practice address
5907 E SANDERLING DR, TUCSON, AZ 85756-8630
(520) 777-6094
Mailing address
5907 E SANDERLING DR, TUCSON, AZ 85756-8630
(520) 777-6094
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
BH3603
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH3603
BEHEVIORAL HEALTH RESIDENTIAL
AZ
Enumeration date
07/10/2010
Last updated
07/10/2010
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