Organization
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC.
Active
Organization
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC.
Active
Other names
Winstel House
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE MARY LOPEZ MBA (PRESIDENT AND CEO)
(520) 721-1887
Entity
Organization
Contact information
Practice address
2902 N WINSTEL BLVD, TUCSON, AZ 85716-2029
(520) 721-1887
(520) 721-0069
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 721-0069
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OTC6193
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
569277
—
AZ
01
—
OTC10340
STATE LICENSE
AZ
Enumeration date
11/10/2010
Last updated
10/09/2020
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