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NPI Code Detail

MEDICARE: HEALTHY TREATING LLC

MEDICARE: HEALTHY TREATING LLC
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
1101Y00000XCounselor
2101YA0400XAddiction (Substance Use Disorder) Counselor
3103K00000XBehavior Analyst
4103TA0400XAddiction (Substance Use Disorder) Psychologist
5103TP0016XPrescribing (Medical) Psychologist
62084P0802XAddiction Psychiatry Physician
7261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1883756877OTHERIRS

General Provider Information

NPI Number : 1215637434
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHY TREATING LLC
Provider Business Mailing Address
First Line : 3825 E SUN VIEW CT
Second Line :
City : TUCSON
State : AZ
Zip : 85706-4983
Country : US
Telephone Number : 920-378-7176
Fax Number :
Provider Business Practice Location Address
First Line : 7740 E SPEEDWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85710-1606
Country : US
Telephone Number : 920-378-7176
Fax Number :
Authorized Official
Title or Position : CEO
Name : MASSO ERIC RUSAMAZA
Credential : BHT
Telephone Number : 920-378-7176
Provider Enumeration Date : 03/07/2023
Last Update Date : 03/10/2023

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