Organization
GOOD MEDICENE HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT M FLORES (EXECUTIVE DIRECTOR)
(520) 301-7883
Entity
Organization
Contact information
Practice address
9221 E DOLORES ST, TUCSON, AZ 85730-2132
(520) 301-7883
Mailing address
301 W AJO WAY, TUCSON, AZ 85713-6040
(520) 301-7883
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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