Healthcare Provider Details

I. General information

NPI: 1003560988
Provider Name (Legal Business Name): SIERRA TUCSON OP AZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8035 N 85TH WAY
SCOTTSDALE AZ
85258-4321
US

IV. Provider business mailing address

6100 TOWER CIR STE 1000
FRANKLIN TN
37067-1509
US

V. Phone/Fax

Practice location:
  • Phone: 520-624-4000
  • Fax:
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN P. FARLEY
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000