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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