| Ics | |
|
4761 E Camp Lowell Dr Tucson AZ 85712-1256 | |
| (520) 403-4798 | |
| Not Available |
| Full Name | Ics |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4761 E Camp Lowell Dr, Tucson, Arizona |
| Authorized Official Name and Position | Sanjay Manchanda (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5204034798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ics 1624 E Calle Altivo Tucson AZ 85718-5807 Ph: (520) 403-4798 | Ics 4761 E Camp Lowell Dr Tucson AZ 85712-1256 Ph: (520) 403-4798 |
| NPI Number | 1366628042 |
|---|---|
| Provider Enumeration Date | 01/12/2008 |
| Last Update Date | 04/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366628042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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