| Supported Living Systems | |
|
925 S Craycroft Rd Tucson AZ 85711-7112 | |
| (520) 514-9888 | |
| (520) 514-9878 |
| Full Name | Supported Living Systems |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 925 S Craycroft Rd, Tucson, Arizona |
| Authorized Official Name and Position | Richard Eck (CEO) |
| Authorized Official Contact | 5205149888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supported Living Systems 925 S Craycroft Rd Tucson AZ 85711-7112 Ph: (520) 514-9888 | Supported Living Systems 925 S Craycroft Rd Tucson AZ 85711-7112 Ph: (520) 514-9888 |
| NPI Number | 1356499750 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356499750 | NPI | - | NPPES |
| BH-2160 | Other | AZ | AZ BEHAVIORAL LICENSE # |
| 779647 | Other | AZ | AHCCCS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-2160 (Arizona) | Primary |
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