| Milagro Behavioral Health | |
|
6375 E Tanque Verde Rd Ste 140 Tucson AZ 85715-3863 | |
| (520) 885-4679 | |
| (520) 296-9556 |
| Full Name | Milagro Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6375 E Tanque Verde Rd Ste 140, Tucson, Arizona |
| Authorized Official Name and Position | Shannon Lorraine Padilla (OWNER) |
| Authorized Official Contact | 5209908107 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milagro Behavioral Health 6375 E Tanque Verde Rd Ste 140 Tucson AZ 85715-3863 Ph: (520) 885-4679 | Milagro Behavioral Health 6375 E Tanque Verde Rd Ste 140 Tucson AZ 85715-3863 Ph: (520) 885-4679 |
| NPI Number | 1629624911 |
|---|---|
| Provider Enumeration Date | 08/13/2019 |
| Last Update Date | 10/30/2019 |
| Medicare PECOS PAC ID | 6204269954 |
|---|---|
| Medicare Enrollment ID | O20191210003180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629624911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Shannon L Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871840520 PECOS PAC ID: 9739339441 Enrollment ID: I20121015000384 |
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