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NPI Code Detail

MEDICARE: ALEKSEI L BLANCO

MEDICARE:   ALEKSEI L BLANCO
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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1982532917
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEKSEI L BLANCO
Provider Business Mailing Address
First Line : 2502 S PALM SPRINGS DR
Second Line :
City : TUCSON
State : AZ
Zip : 85710-7935
Country : US
Telephone Number : 520-449-4431
Fax Number :
Provider Business Practice Location Address
First Line : 2611 S SARNOFF DR
Second Line :
City : TUCSON
State : AZ
Zip : 85730-1206
Country : US
Telephone Number : 520-449-4431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “ ALEKSEI L BLANCO ” Practice Location

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