Organization
ARIZONA RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH O. WALKER (CHIEF EXECUTIVE OFFICER)
(520) 664-5192
Entity
Organization
Contact information
Practice address
2226 N AVENIDA EL CAPITAN, TUCSON, AZ 85705-5741
(520) 882-1986
(520) 882-1987
Mailing address
PO BOX 77057, TUCSON, AZ 85703-7057
(520) 882-1986
(520) 882-1987
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH2456
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
891467
AHCCCS
AZ
Enumeration date
09/20/2006
Last updated
08/22/2020
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