| Ppep Integrated Care | |
|
901 E 46th St Tucson AZ 85713-5008 | |
| (520) 792-5704 | |
| (520) 792-5724 |
| Full Name | Ppep Integrated Care |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 901 E 46th St, Tucson, Arizona |
| Authorized Official Name and Position | John David Arnold (CEO/FOUNDER) |
| Authorized Official Contact | 5206223553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppep Integrated Care 802 E 46th St Tucson AZ 85713-5006 Ph: (520) 622-3553 | Ppep Integrated Care 901 E 46th St Tucson AZ 85713-5008 Ph: (520) 792-5704 |
| NPI Number | 1225135502 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 12/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225135502 | NPI | - | NPPES |
| 134958 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CSLG7856 (Arizona) | Primary |
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