Healthcare Provider Details

I. General information

NPI: 1932019874
Provider Name (Legal Business Name): OLD PUEBLO COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 S PARK AVE
TUCSON AZ
85713-3644
US

IV. Provider business mailing address

2323 S PARK AVE
TUCSON AZ
85713-3644
US

V. Phone/Fax

Practice location:
  • Phone: 520-437-3601
  • Fax: 520-777-4512
Mailing address:
  • Phone: 520-437-3601
  • Fax: 520-777-4512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MICHAEL LITWICKI
Title or Position: CEO
Credential: LIAC 1100
Phone: 520-437-3601