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General NPI Number Information
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NPI Number | 1912178997
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Entity Type | Organization
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Legal Business Name | PASCUA YAQUI TRIBE
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 9405 S AVENIDA DEL YAQUI
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City | GUADALUPE
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State | AZ
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Zip | 85283-2529
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Country | US
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Telephone | 480-768-2021
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Fax | 480-768-2053
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Provider Business Mailing Address
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Address Line | 7490 S CAMINO DE OESTE
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City | TUCSON
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State | AZ
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Zip | 85746-9308
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Country | US
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Telephone | 520-879-6060
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Fax | 520-879-6099
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | LINDA GUERRERO
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Credential |
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Telephone | 520-879-6039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2283
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License Number State | AZ
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