| Casa De Los Ninos | |
|
1120 N 5th Avenue Tucson AZ 85705 | |
| (520) 624-5600 | |
| (520) 623-2443 |
| Full Name | Casa De Los Ninos |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1120 N 5th Avenue, Tucson, Arizona |
| Authorized Official Name and Position | Jessica Velarde (ADMINISTRATIVE ANALYST) |
| Authorized Official Contact | 5204712206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Casa De Los Ninos 1120 N 5th Avenue Tucson AZ 85705 Ph: (520) 624-5600 | Casa De Los Ninos 1120 N 5th Avenue Tucson AZ 85705 Ph: (520) 624-5600 |
| NPI Number | 1730681685 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 01/14/2021 |
| Certification Date | 01/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730681685 | NPI | - | NPPES |
| 502818 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PENDING (Arizona) | Secondary |
| 251S00000X | Community/behavioral Health | OTC-8835 (Arizona) | Primary |
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