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NPI Code Detail

MEDICARE: INTRACOASTAL BEHAVIORAL HEALTH RECOVERY & WELLNESS LLC

MEDICARE: INTRACOASTAL BEHAVIORAL HEALTH RECOVERY & WELLNESS 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1285598466
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTRACOASTAL BEHAVIORAL HEALTH RECOVERY & WELLNESS LLC
Provider Business Mailing Address
First Line : 5151 E BROADWAY BLVD STE 1700
Second Line :
City : TUCSON
State : AZ
Zip : 85711-3788
Country : US
Telephone Number : 520-286-2503
Fax Number :
Provider Business Practice Location Address
First Line : 5151 E BROADWAY BLVD STE 1700
Second Line :
City : TUCSON
State : AZ
Zip : 85711-3788
Country : US
Telephone Number : 520-286-2503
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. SOPHIA FALANA
Credential : DNP-PMNP-BC
Telephone Number : 520-286-2503
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “INTRACOASTAL BEHAVIORAL HEALTH RECOVERY & WELLNESS LLC ” Practice Location

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