| Pascua Yaqui Tribe | |
|
7490 S Camino De Oeste Tucson AZ 85746-9308 | |
| (520) 879-6060 | |
| (520) 879-6099 |
| Full Name | Pascua Yaqui Tribe |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7490 S Camino De Oeste, Tucson, Arizona |
| Authorized Official Name and Position | Rosa M. Rivera (BUSINESS MANAGER) |
| Authorized Official Contact | 5208796060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pascua Yaqui Tribe 7490 S Camino De Oeste Tucson AZ 85746-9308 Ph: (520) 879-6060 | Pascua Yaqui Tribe 7490 S Camino De Oeste Tucson AZ 85746-9308 Ph: (520) 879-6060 |
| NPI Number | 1144350257 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144350257 | NPI | - | NPPES |
| 054317 | Medicaid | AZ | |
| 846727 | Medicaid | AZ | |
| 218075 | Medicaid | AZ | |
| 553869 | Medicaid | AZ | |
| 716011 | Medicaid | AZ | |
| 854580 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 218075 (Arizona) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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