Individual
ROSA VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1096 S 202ND LN, BUCKEYE, AZ 85326-8283
(623) 698-1270
(520) 407-5398
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 407-5398
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
9227214
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9227214
THERAPEUTIC FOSTER CARE
AZ
Enumeration date
07/20/2022
Last updated
07/20/2022
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