Organization
CODAC HEALTH, RECOVERY & WELLNESS, INC.
Active
Other names
CODAC Santa Rosa
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS REGNIER (CEO)
(520) 327-4505
Entity
Organization
Contact information
Practice address
1080 S 10TH AVE, TUCSON, AZ 85701-2907
(520) 623-3533
(520) 594-6345
Mailing address
1650 E FORT LOWELL RD, SUITE 202, TUCSON, AZ 85719-2374
(520) 327-4505
(520) 202-1889
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
BH-3922
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
653946
—
AZ
Enumeration date
10/03/2011
Last updated
09/25/2015
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