Individual
TOATE GANAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6781 S AQUILINE DR, TUCSON, AZ 85756-8639
(520) 319-0778
(520) 296-8244
Mailing address
6781 S AQUILINE DR, TUCSON, AZ 85756-8639
(520) 319-0778
(520) 296-8244
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
BH4917
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
BH4917
AZ
385H00000X
Respite Care
BH4917
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH4917
AZ DHS LICENSE
AZ
Enumeration date
06/29/2016
Last updated
12/03/2024
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