| Devereux Arizona | |
|
6141 E Grant Rd Tucson AZ 85712-5829 | |
| (520) 296-5551 | |
| Not Available |
| Full Name | Devereux Arizona |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 6141 E Grant Rd, Tucson, Arizona |
| Authorized Official Name and Position | Lane Martin-barker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4809982920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Devereux Arizona 11000 N Scottsdale Rd Ste 260 Scottsdale AZ 85254-5270 Ph: (480) 998-2920 | Devereux Arizona 6141 E Grant Rd Tucson AZ 85712-5829 Ph: (520) 296-5551 |
| NPI Number | 1003913385 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003913385 | NPI | - | NPPES |
| 448713 | Other | AZ | AHCCCS ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | BH-721 (Arizona) | Primary |
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