Organization
UNIVERSITY OF ARIZONARISE-RSSI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDA M KUTOB MD (MEDICAL DIRECTOR)
(520) 621-1642
Entity
Organization
Contact information
Practice address
1030 N ALVERNON WAY, TUCSON, AZ 85711-1020
(520) 621-1642
(520) 626-7833
Mailing address
1030 N ALVERNON WAY, TUCSON, AZ 85711-1020
(520) 621-1642
(520) 626-7833
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSA12ADHS0204
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CSA12ADHS0204
—
AZ
Enumeration date
10/19/2012
Last updated
04/17/2026
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