Organization
MIRASOL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANNE RUST PHD (EXECUTIVE DIRECTOR)
(520) 546-3200
Entity
Organization
Contact information
Practice address
10490 E ESCALANTE RD, TUCSON, AZ 85730-5502
(520) 546-3200
(520) 546-3205
Mailing address
2954 N CAMPBELL AVE # 157, TUCSON, AZ 85719-2813
(520) 546-3200
(520) 546-3205
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
BH 4529
AZ
Other
Enumeration date
12/19/2006
Last updated
04/15/2015
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