Corazon Behavioral Health Services | |
900 E Florence Blvd Ste G Casa Grande AZ 85122-4673 | |
(520) 836-4278 | |
(520) 836-1786 |
Full Name | Corazon Behavioral Health Services |
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Speciality | Counselor |
Location | 900 E Florence Blvd Ste G, Casa Grande, Arizona |
Authorized Official Name and Position | Leticia Martinez (CEO/CLINICAL DIRECTOR) |
Authorized Official Contact | 5208364278 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Corazon Behavioral Health Services 900 E. Florence Blvd. Ste G. Casa Grande AZ 85122-4666 Ph: (520) 836-4278 | Corazon Behavioral Health Services 900 E Florence Blvd Ste G Casa Grande AZ 85122-4673 Ph: (520) 836-4278 |
NPI Number | 1841277969 |
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Provider Enumeration Date | 12/29/2005 |
Last Update Date | 11/04/2024 |
Certification Date | 11/04/2024 |
Medicare PECOS PAC ID | 3375718240 |
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Medicare Enrollment ID | O20111206000114 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841277969 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | BH2129 (Arizona) | Primary |
Provider Name | Richelle Ramirez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396817862 PECOS PAC ID: 2062451750 Enrollment ID: I20050502001197 |
Provider Name | Linda M Banziger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467695726 PECOS PAC ID: 6800925371 Enrollment ID: I20120302000660 |
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