| Intermountain Centers For Human Development Inc. | |
|
Tohono Plaza Bldg 4 Ste 405 Bia State Route 19 Sells AZ 85634 | |
| (520) 721-1887 | |
| (520) 407-5397 |
| Full Name | Intermountain Centers For Human Development Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | Tohono Plaza Bldg 4 Ste 405 Bia State Route 19, Sells, Arizona |
| Authorized Official Name and Position | Rose Mary 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 Centers For Human Development Inc. Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | Intermountain Centers For Human Development Inc. Tohono Plaza Bldg 4 Ste 405 Bia State Route 19 Sells AZ 85634 Ph: (520) 721-1887 |
| NPI Number | 1205164605 |
|---|---|
| Provider Enumeration Date | 11/23/2009 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205164605 | NPI | - | NPPES |
| 508246 | Medicaid | AZ | |
| BH5148 | Other | AZ | TRIBAL MOU |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Dhhs-phs, Ihs Tucson Area, Ihs Tucson Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Highway 86 At Topawa Road, Sells, AZ 85634 Phone: 520-383-7251 Fax: 520-383-7216 |