MEDICARE: CATHEXIS TUCSON, 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
1	101Y00000X	Counselor

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

General Provider Information

NPI Number	:	1942779095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHEXIS TUCSON, LLC

Provider Business Mailing Address
First Line	:	6280 E PIMA ST STE 100
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3074
Country	:	US
Telephone Number	:	520-329-1250
Fax Number	:

Provider Business Practice Location Address
First Line	:	4750 N ORACLE RD STE 106
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-1676
Country	:	US
Telephone Number	:	520-329-1250
Fax Number	:

Authorized Official
Title or Position	:	CAO
Name	:	SUSAN CONDOS MILLS
Credential	:
Telephone Number	:	520-271-0628

Provider Enumeration Date	:	11/19/2018
Last Update Date	:	11/19/2018

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