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936 F Ave Ste A&b Douglas AZ 85607-2001 | |
| (520) 836-4278 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 936 F Ave Ste A&b, Douglas, Arizona |
| Authorized Official Name and Position | Teresa Menachaca (CEO) |
| Authorized Official Contact | 5208364278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
900 E Florence Blvd Casa Grande AZ 85122-4666 Ph: (520) 836-4278 | 936 F Ave Ste A&b Douglas AZ 85607-2001 Ph: (520) 836-4278 |
| NPI Number | 1346675394 |
|---|---|
| Provider Enumeration Date | 09/10/2013 |
| Last Update Date | 09/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346675394 | NPI | - | NPPES |
| 584944 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4382 (Arizona) | Primary |
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