|
| |
|
4755 Campus Drive Sierra Vista AZ 85635 | |
| (520) 458-3932 | |
| (520) 458-3585 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4755 Campus Drive, Sierra Vista, Arizona |
| Authorized Official Name and Position | Estella Hernandez (CONTRACTS & CREDENTIALING ADMIN) |
| Authorized Official Contact | 5208385513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
611 W Union St Benson AZ 85602-6718 Ph: (520) 586-0800 | 4755 Campus Drive Sierra Vista AZ 85635 Ph: (520) 458-3932 |
| NPI Number | 1326215955 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 06/10/2022 |
| Certification Date | 06/10/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326215955 | NPI | - | NPPES |
| 336159 | Medicaid | AZ | |
| OTC-6892 | Other | AZ | ADHS LICENSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-3043 (Arizona) | Primary |
Generations Group Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1763 Paseo San Luis, Sierra Vista, AZ 85635 Phone: 520-459-8433 | |
Mesa Verde Counseling Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2585 E Wilcox Dr Ste A, Sierra Vista, AZ 85635 Phone: 520-442-2812 | |
Best Solutions, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4341 S Highway 92, Unit F, Sierra Vista, AZ 85650 Phone: 520-803-7500 Fax: 520-803-7512 | |
Mikid, Mentally Ill Kids In Distress Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 365 Short St, Sierra Vista, AZ 85635 Phone: 928-333-4330 Fax: 602-840-3409 |