MEDICARE: NATIVE MUSIC COALITION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility
2	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1033756358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIVE MUSIC COALITION

Provider Business Mailing Address
First Line	:	1706 E CALLE SALAMANCA
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85714-1729
Country	:	US
Telephone Number	:	520-262-8262
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 W FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-3814
Country	:	US
Telephone Number	:	520-301-7883
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. VINCENT M FLORES
Credential	:
Telephone Number	:	520-301-7883

Provider Enumeration Date	:	12/05/2019
Last Update Date	:	05/26/2022

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Directions to “NATIVE MUSIC COALITION ” Practice Location

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