Organization
OPEN INN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY PANICO MBA (EXECUTIVE DIRECTOR)
(520) 670-9040
Entity
Organization
Contact information
Practice address
721 NORTH GONZALES BOULEVARD, HUACHUCA CITY, AZ 85616-4338
(520) 456-1000
(520) 456-1323
Mailing address
PO BOX 5766, TUCSON, AZ 85703-0766
(520) 670-9040
(520) 670-1753
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A6
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
837461
AHCCCS #
AZ
Enumeration date
05/07/2007
Last updated
07/21/2022
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