Organization
MIRASOL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY LESTER MBA (DIRECTOR)
(520) 546-3200
Entity
Organization
Contact information
Practice address
3116 N SWAN RD, TUCSON, AZ 85712-1227
(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
261QM0850X
Adult Mental Health Clinic/Center
Primary
OTC 6713
AZ
Other
Enumeration date
02/13/2013
Last updated
04/16/2015
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