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General NPI Number Information
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NPI Number | 1063898260
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Entity Type | Organization
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Legal Business Name | REGIONAL CENTER FOR BORDER HEALTH, INC
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 1130 E MAIN ST
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City | SOMERTON
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State | AZ
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Zip | 85350-7413
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Country | US
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Telephone | 928-627-2017
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | SOMERTON
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State | AZ
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Zip | 85350-0617
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Country | US
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Telephone | 928-315-7910
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | AMANDA AGUIRRE
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Credential | REGISTERED DIETICIAN
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Telephone | 928-315-7910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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