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General NPI Number Information
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NPI Number | 1013249564
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Entity Type | Organization
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Legal Business Name | HEDRICK HOUSE INC.
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 1632 E HEDRICK DR
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City | TUCSON
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State | AZ
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Zip | 85719-2790
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Country | US
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Telephone | 520-795-3334
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Fax | 520-795-1352
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Provider Business Mailing Address
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Address Line | 1632 E HEDRICK DR
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City | TUCSON
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State | AZ
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Zip | 85719-2790
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Country | US
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Telephone | 520-795-3334
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Fax | 520-795-1352
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Authorized Official
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Title or Position | MANAGER
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Name | MR. EDWARD ANDREW KOLARICH
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Credential |
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Telephone | 520-795-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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