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NPI Code Detail

MEDICARE: OLA MT BAKIR

MEDICARE: OLA MT BAKIR
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
1385HR2055XChild Mental Illness Respite Care8495479AZ
2253J00000XFoster Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154827830
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLA MT BAKIR
Provider Business Mailing Address
First Line : 1161 N EL DORADO PL STE 103
Second Line :
City : TUCSON
State : AZ
Zip : 85715-4607
Country : US
Telephone Number : 520-748-7108
Fax Number :
Provider Business Practice Location Address
First Line : 8803 N YELLOW MOON DR
Second Line :
City : TUCSON
State : AZ
Zip : 85743-8505
Country : US
Telephone Number : 520-891-4664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2018
Last Update Date : 08/27/2021

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Directions to “ OLA MT BAKIR ” Practice Location

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