Organization
CASA DE LOS NINOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSIE DYER RN BSN (SUPERVISOR OF MEDICAL SERVICES)
(520) 624-5600
Entity
Organization
Contact information
Practice address
1138 N. 5TH AVE., TUCSON, AZ 85705
(520) 624-5600
(520) 792-0009
Mailing address
1101 N 4TH AVE, TUCSON, AZ 85705-7467
(520) 624-5600
(520) 792-0009
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
385189
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
385189
AHCCCS PROVIDER #
AZ
Enumeration date
06/04/2007
Last updated
08/22/2020
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