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General NPI Number Information
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NPI Number | 1881896561
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Entity Type | Organization
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Legal Business Name | CASA DE LOS NINOS
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1138 N. 5TH AVE.
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City | TUCSON
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State | AZ
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Zip | 85705
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Country | US
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Telephone | 520-624-5600
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Fax | 520-792-0009
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Provider Business Mailing Address
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Address Line | 1101 N 4TH AVE
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City | TUCSON
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State | AZ
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Zip | 85705-7467
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Country | US
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Telephone | 520-624-5600
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Fax | 520-792-0009
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Authorized Official
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Title or Position | SUPERVISOR OF MEDICAL SERVICES
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Name | MS. ROSIE DYER
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Credential | RN BSN
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Telephone | 520-624-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 385189
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License Number State | AZ
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