Individual
MR. JUAN M VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NONE
Contact information
Practice address
9264 S. WILT BANK ROAD, TUCSON, AZ 85735
(520) 440-0630
(520) 319-5491
Mailing address
9264 S. WILT BANK RD., TUCSON, AZ 85735
(520) 440-0630
(520) 319-5491
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
2433
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2433
BEHAVIORAL HEALTH NUMBER
AZ
Enumeration date
02/06/2007
Last updated
07/08/2007
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