Individual
CECILIA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6942 S 12TH AVE, TUCSON, AZ 85756-6502
(520) 256-8971
Mailing address
6942 S 12TH AVE, TUCSON, AZ 85756-6502
(520) 256-8971
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
AZ
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
302F00000X
Exclusive Provider Organization
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
373H00000X
Day Training/Habilitation Specialist
—
AZ
373H00000X
Day Training/Habilitation Specialist
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156308
AHCCCS ID
AZ
Enumeration date
08/04/2022
Last updated
03/24/2024
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