Healthcare Provider Details

I. General information

NPI: 1952014102
Provider Name (Legal Business Name): PRESENT HOPE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 W AHMED AVE
TUCSON AZ
85704-1203
US

IV. Provider business mailing address

1915 W AHMED AVE
TUCSON AZ
85704-1203
US

V. Phone/Fax

Practice location:
  • Phone: 520-848-6404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: GABRIEL LOBATO
Title or Position: OWNER
Credential:
Phone: 520-848-6404