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General NPI Number Information
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NPI Number | 1700998002
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Entity Type | Organization
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Legal Business Name | PASADERA BEHAVIORAL HEALTH NETWORK
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 302 W. VENTURA ST.
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City | TUCSON
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State | AZ
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Zip | 85705-5478
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Country | US
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Telephone | 520-620-0188
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Fax | 520-620-0197
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Provider Business Mailing Address
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Address Line | 2700 S 8TH AVE
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City | TUCSON
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State | AZ
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Zip | 85713-4730
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Country | US
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Telephone | 520-628-3400
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Fax | 520-628-3401
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Authorized Official
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Title or Position | DIRECTOR OF QM
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Name | STEPHANIE OLIVER
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Credential | CPC, RMM, ICD10CT-CM
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Telephone | 520-628-3400
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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 | BH-3687
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License Number State | AZ
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