Organization
CODAC HEALTH RECOVERY AND WELLNESS
Active
Other names
CODAC at Speedway
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL AXINN (CONTRACTS AND CREDENTIALING MANAGER)
(520) 202-1755
Entity
Organization
Contact information
Practice address
4585 E SPEEDWAY BLVD, TUCSON, AZ 85712-5309
(520) 327-4505
(520) 202-1889
Mailing address
1650 E FORT LOWELL RD STE 202, TUCSON, AZ 85719-2378
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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