| Corazon Behavioral Health Services | |
|
900 E Florence Blvd Suite G Casa Grande AZ 85222-4666 | |
| (520) 836-4278 | |
| (520) 836-1786 |
| Full Name | Corazon Behavioral Health Services |
|---|---|
| Speciality | Counselor |
| Location | 900 E Florence Blvd, Casa Grande, Arizona |
| Authorized Official Name and Position | Tricia Foster (CEO) |
| Authorized Official Contact | 5208364278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corazon Behavioral Health Services 900 E Florence Blvd Suite G Casa Grande AZ 85122-4666 Ph: (520) 836-4278 | Corazon Behavioral Health Services 900 E Florence Blvd Suite G Casa Grande AZ 85222-4666 Ph: (520) 836-4278 |
| NPI Number | 1841277969 |
|---|---|
| Provider Enumeration Date | 12/29/2005 |
| Last Update Date | 01/14/2015 |
| Medicare PECOS PAC ID | 3375718240 |
|---|---|
| Medicare Enrollment ID | O20111206000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841277969 | NPI | - | NPPES |
| 716251 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | BH2129 (Arizona) | Primary |
| Provider Name | Richelle Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396817862 PECOS PAC ID: 2062451750 Enrollment ID: I20050502001197 |
| Provider Name | Linda M Banziger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467695726 PECOS PAC ID: 6800925371 Enrollment ID: I20120302000660 |
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