| Codac At Alvernon | |
|
630 N Alvernon Way Ste 161 Tucson AZ 85711-1843 | |
| (520) 318-9222 | |
| (520) 318-3443 |
| Full Name | Codac At Alvernon |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 630 N Alvernon Way, Tucson, Arizona |
| Authorized Official Name and Position | Dennis Regnier (CEO) |
| Authorized Official Contact | 5203274505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Codac At Alvernon 1650 E Fort Lowell Rd Ste 202 Tucson AZ 85719-2374 Ph: (520) 327-4505 | Codac At Alvernon 630 N Alvernon Way Ste 161 Tucson AZ 85711-1843 Ph: (520) 318-9222 |
| NPI Number | 1174862007 |
|---|---|
| Provider Enumeration Date | 02/13/2013 |
| Last Update Date | 09/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174862007 | NPI | - | NPPES |
| 805051 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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