| Intermountain Health Center, Inc. | |
|
272 West Viewpoint Drive Nogales AZ 85621 | |
| (520) 281-0678 | |
| (520) 281-0678 |
| Full Name | Intermountain Health Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 272 West Viewpoint Drive, Nogales, Arizona |
| Authorized Official Name and Position | Rose M. Lopez (PRESIDENT AND CEO) |
| Authorized Official Contact | 5207211887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Health Center, Inc. Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | Intermountain Health Center, Inc. 272 West Viewpoint Drive Nogales AZ 85621 Ph: (520) 281-0678 |
| NPI Number | 1548771033 |
|---|---|
| Provider Enumeration Date | 10/24/2017 |
| Last Update Date | 01/03/2020 |
| Certification Date | 01/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548771033 | NPI | - | NPPES |
| OTC8493 | Other | AZ | ADHS/BMFL LICENSE |
| 333689 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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