Organization
THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LEE (FINANCE DIRECTOR)
(520) 582-4718
Entity
Organization
Contact information
Practice address
16286 S. SUNLAND GIN RD, ARIZONA CITY, AZ 85123-8512
(480) 298-7301
Mailing address
PO BOX 4293, ARIZONA CITY, AZ 85123-2669
(480) 298-7301
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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