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NPI Code Detail

MEDICARE: MARANA HEALTH CENTER, INC.

MEDICARE: MARANA HEALTH CENTER, INC.
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
1251S00000XCommunity/Behavioral Health AgencyBH-4181AZ

General Provider Information

NPI Number : 1497199889
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARANA HEALTH CENTER, INC.
Provider Business Mailing Address
First Line : PO BOX 188
Second Line :
City : MARANA
State : AZ
Zip : 85653-0188
Country : US
Telephone Number : 520-682-4111
Fax Number : 520-818-3630
Provider Business Practice Location Address
First Line : 3690 S PARK AVE STE 805
Second Line :
City : TUCSON
State : AZ
Zip : 85713-5042
Country : US
Telephone Number : 520-616-6760
Fax Number : 520-616-6799
Authorized Official
Title or Position : CEO
Name : CLARENCE G VATNE
Credential :
Telephone Number : 520-682-4111
Provider Enumeration Date : 04/29/2013
Last Update Date : 04/29/2013

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Directions to “MARANA HEALTH CENTER, INC. ” Practice Location

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