| Banner -- University Medicine Crisis Response Center Llc | |
|
2802 E District St Fl 2 Tucson AZ 85714-2081 | |
| (602) 253-5100 | |
| Not Available |
| Full Name | Banner -- University Medicine Crisis Response Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2802 E District St Fl 2, Tucson, Arizona |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner -- University Medicine Crisis Response Center Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner -- University Medicine Crisis Response Center Llc 2802 E District St Fl 2 Tucson AZ 85714-2081 Ph: (602) 253-5100 |
| NPI Number | 1174997092 |
|---|---|
| Provider Enumeration Date | 11/16/2015 |
| Last Update Date | 12/28/2021 |
| Certification Date | 12/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174997092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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