| Eleventh Hours Fountain Of Youth Llc | |
|
1025 E Silverlake Rd Tucson AZ 85713-3227 | |
| (480) 869-5550 | |
| Not Available |
| Full Name | Eleventh Hours Fountain Of Youth Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1025 E Silverlake Rd, Tucson, Arizona |
| Authorized Official Name and Position | Brittany C Lyles (OWNER) |
| Authorized Official Contact | 4808695550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eleventh Hours Fountain Of Youth Llc 1254 E 24th St Tucson AZ 85713-1846 Ph: () - | Eleventh Hours Fountain Of Youth Llc 1025 E Silverlake Rd Tucson AZ 85713-3227 Ph: (480) 869-5550 |
| NPI Number | 1811693203 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 02/07/2023 |
| Certification Date | 02/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811693203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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