MEDICARE: LAFRONTERA 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
1	261QM2800X	Methadone Clinic

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	OTC6257	OTHER	AZ	BH LICENSE

General Provider Information

NPI Number	:	1548361470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAFRONTERA CENTER INC

Provider Business Mailing Address
First Line	:	504 W 29TH ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85713-3353
Country	:	US
Telephone Number	:	520-884-9920
Fax Number	:	520-792-0654

Provider Business Practice Location Address
First Line	:	260 S SCOTT AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-1919
Country	:	US
Telephone Number	:	520-884-8470
Fax Number	:	520-620-0434

Authorized Official
Title or Position	:	EVP/COO
Name	:	KATHY GUZMAN WELLS
Credential	:
Telephone Number	:	520-838-5501

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	03/24/2026

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Directions to “LAFRONTERA CENTER INC ” Practice Location

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