Organization
PASADERA BEHAVIORAL HEALTH NETWORK, INC.
Active
Parent organization
PASADERA BEHAVIORAL HEALTH NETWORK, INC.
Other names
Dodge Detoxification Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PASADERA BEHAVIORAL HEALTH NETWORK, INC.
Authorized official
STEPHANIE OLIVER CPC, RMM, ICD10CT-CM (CHIEF QUALITY MANAGEMENT OFFICER)
(520) 628-3400
Entity
Organization
Contact information
Practice address
2502 N DODGE BLVD, SUITE 190, TUCSON, AZ 85716-2671
(520) 618-8600
(520) 617-1608
Mailing address
2700 S 8TH AVE, TUCSON, AZ 85713-4730
(520) 628-3400
(520) 628-3401
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
IFBH7082
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019108
—
AZ
01
—
IFBH7082
STATE LICENSE
AZ
Enumeration date
04/06/2015
Last updated
08/13/2015
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