| Tusa Saddle Behavioral Health Services Llc | |
|
615 W Cottonwood Ln Ste 5 Casa Grande AZ 85122-2250 | |
| (702) 849-2173 | |
| Not Available |
| Full Name | Tusa Saddle Behavioral Health Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 615 W Cottonwood Ln Ste 5, Casa Grande, Arizona |
| Authorized Official Name and Position | Isaac Mutabazi (CEO) |
| Authorized Official Contact | 7028492173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tusa Saddle Behavioral Health Services Llc 7728 Coronado Island St Las Vegas NV 89139-6298 Ph: (702) 849-2173 | Tusa Saddle Behavioral Health Services Llc 615 W Cottonwood Ln Ste 5 Casa Grande AZ 85122-2250 Ph: (702) 849-2173 |
| NPI Number | 1770260887 |
|---|---|
| Provider Enumeration Date | 06/29/2023 |
| Last Update Date | 06/29/2023 |
| Certification Date | 06/29/2023 |
| Medicare PECOS PAC ID | 2769835974 |
|---|---|
| Medicare Enrollment ID | O20240124001554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770260887 | NPI | - | NPPES |
| Provider Name | Jacquette Shineese Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013543750 PECOS PAC ID: 5193175263 Enrollment ID: I20240102002534 |
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