| La Frontera Center, Inc. | |
|
4891 E Grant Rd Tucson AZ 85712-2704 | |
| (520) 296-3296 | |
| Not Available |
| Full Name | La Frontera Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4891 E Grant Rd, Tucson, Arizona |
| Authorized Official Name and Position | Kathy Wells (EVP/COO) |
| Authorized Official Contact | 5208385501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Frontera Center, Inc. 504 W 29th St Tucson AZ 85713-3353 Ph: (520) 838-5600 | La Frontera Center, Inc. 4891 E Grant Rd Tucson AZ 85712-2704 Ph: (520) 296-3296 |
| NPI Number | 1811098742 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 07/12/2024 |
| Certification Date | 07/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811098742 | NPI | - | NPPES |
| 068233 | Medicaid | AZ | |
| OTC6231 | Other | AZ | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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