Organization
COBROS III, LLC
Active
Other names
Desert Horizons Communities
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD COLONNA (BUSINESS MANAGER)
(520) 615-2255
Entity
Organization
Contact information
Practice address
7336 E 28TH PL, TUCSON, AZ 85710-5559
(520) 615-2255
Mailing address
PO BOX 43908, TUCSON, AZ 85733-3908
(520) 615-2255
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
405971
AZ
310500000X
Mental Illness Intermediate Care Facility
405971
AZ
315P00000X
Intellectual Disabilities Intermediate Care Facility
405971
AZ
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
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Other
Enumeration date
12/23/2015
Last updated
09/30/2016
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