Healthcare Provider Details

I. General information

NPI: 1245019371
Provider Name (Legal Business Name): TUSA NGEFOR BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W ADAMSVILLE RD
FLORENCE AZ
85132-8582
US

IV. Provider business mailing address

3338 W SILVERDALE RD
SAN TAN VLY AZ
85144-1673
US

V. Phone/Fax

Practice location:
  • Phone: 623-433-5236
  • Fax:
Mailing address:
  • Phone: 901-273-5064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. NATALIE ABO TAMASANG-ANAGHO
Title or Position: OWNER
Credential:
Phone: 901-273-5064