Organization
LA FRONTERA CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY WELLS (COO)
(520) 838-5501
Entity
Organization
Contact information
Practice address
502 W. 29TH STREET, TUCSON, AZ 85713-3353
(520) 884-9920
(520) 792-0654
Mailing address
502 W. 29TH STREET, TUCSON, AZ 85713-3353
(520) 884-9920
(520) 792-0654
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
CDC-1877
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
534364
—
AZ
Enumeration date
10/12/2006
Last updated
08/22/2020
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