| Codac At Desert Life | |
|
2001 W Orange Grove Rd Ste 416 Tucson AZ 85704-1139 | |
| (520) 327-4505 | |
| (520) 202-1889 |
| Full Name | Codac At Desert Life |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2001 W Orange Grove Rd, 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 Desert Life 1650 E Fort Lowell Rd Ste 202 Tucson AZ 85719-2374 Ph: (520) 327-4505 | Codac At Desert Life 2001 W Orange Grove Rd Ste 416 Tucson AZ 85704-1139 Ph: (520) 327-4505 |
| NPI Number | 1235569328 |
|---|---|
| Provider Enumeration Date | 11/26/2013 |
| Last Update Date | 09/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235569328 | NPI | - | NPPES |
| 025747 | Medicaid | AZ |
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