Organization
CODAC HEALTH, RECOVERY & WELLNESS, INC.
Active
Other names
Gila House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS REGNIER (PRESIDENT & CEO)
(520) 327-4505
Entity
Organization
Contact information
Practice address
2482 N PALO VERDE AVE, TUCSON, AZ 85716-2548
(520) 327-4505
(520) 202-1889
Mailing address
1650 E FORT LOWELL RD, STE 202, TUCSON, AZ 85719-2374
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5053
LICENSE
AZ
Enumeration date
10/20/2016
Last updated
12/27/2016
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