| Pantano Behavioral Health Services, Inc. | |
|
5055 E Broadway Blvd Ste C104 Tucson AZ 85711-3641 | |
| (520) 623-9833 | |
| (520) 623-9083 |
| Full Name | Pantano Behavioral Health Services, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 5055 E Broadway Blvd Ste C104, Tucson, Arizona |
| Authorized Official Name and Position | Marissa S Arendt (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 5206239833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pantano Behavioral Health Services, Inc. 5055 E Broadway Blvd Ste C104 Tucson AZ 85711-3641 Ph: (520) 623-9833 | Pantano Behavioral Health Services, Inc. 5055 E Broadway Blvd Ste C104 Tucson AZ 85711-3641 Ph: (520) 623-9833 |
| NPI Number | 1205842705 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 11/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205842705 | NPI | - | NPPES |
| 772576 | Other | AZ | AHCCCS ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | BH-2183 (Arizona) | Primary |
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