SUPPORTED LIVING SYSTEMS NPI 1093864340

NPI Information

NPI: 1093864340
Provider Name: SUPPORTED LIVING SYSTEMS

Other Name: SAGUARO HOUSE

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
5120 E ALBERTA DR
TUCSON, AZ
ZIP 85711
Phone: (520) 514-7840
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SUPPORTED LIVING SYSTEMS is a residential treatment facility emotionally disturbed children in Tucson, AZ. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. SUPPORTED LIVING SYSTEMS NPI is 1093864340. The provider is registered as an organization entity type.
The provider Other Name Is Saguaro House.

The provider's business location address is:

5120 E ALBERTA DR
TUCSON, AZ
ZIP 85711-119
Phone: (520) 514-7840

The provider's authorized official is Richard Eck .
The authorized official title is Ceo and has the following contact phone number (520) 514-9888.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		BH-1883	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BH-1883	OTHER	ARIZONA	AZ BEHAVIORAL LICENSE #
2	593493	OTHER	ARIZONA	AHCCS PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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