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General NPI Number Information
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NPI Number | 1275244709
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Entity Type | Organization
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Legal Business Name | PEACOCK MENTAL HEALTH LLC
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Dates
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Enumeration Date | 12/06/2022
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1200 N EL DORADO PL STE E-510
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City | TUCSON
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State | AZ
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Zip | 85715-4637
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Country | US
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Telephone | 623-355-5575
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Fax | 623-227-2466
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Provider Business Mailing Address
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Address Line | 3071 N SWAN RD
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City | TUCSON
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State | AZ
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Zip | 85712-1259
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Country | US
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Telephone | 623-355-5575
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Fax | 623-227-2466
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Authorized Official
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Title or Position | OWNER
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Name | DR. AARON DEL PINO
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Credential | DNP-PMHNP
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Telephone | 520-428-2003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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