Organization
SUPPORTED LIVING SYSTEMS
Active
Other names
Belvedere House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ECK PHD (CEO)
(520) 514-9888
Entity
Organization
Contact information
Practice address
831 N BELVEDERE AVE, TUCSON, AZ 85711-1191
(520) 349-8585
Mailing address
925 S CRAYCROFT RD, TUCSON, AZ 85711-7112
(520) 514-9888
(520) 514-9878
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-2610
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
755811
AHCCCS PROVIDER #
AZ
01
—
BH-2610
AZ BEHAVIORAL LICENSE #
AZ
Enumeration date
01/09/2007
Last updated
08/22/2020
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