03D2155237 CLIA NUMBER - TUCSON RECOVERY AT VILLA MARIA

Laboratory Demographics

CLIA Number: 03D2155237

Facility Name: TUCSON RECOVERY AT VILLA MARIA

Facility Address:
4310 E GRANT ROAD UNIT A
TUCSON, AZ
ZIP 85712
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Facility Phone Number: 520 232-9351

Facility Type: Other - RESIDENTIAL BEHAV. HEALTH

Certificate Type: Waiver

NPI Number: 1154826527

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	03D2155237
LAB Type	Other - RESIDENTIAL BEHAV. HEALTH
Facility Name	TUCSON RECOVERY AT VILLA MARIA
Street	4310 E GRANT ROAD UNIT A
City	TUCSON
State	AZ
ZIP	85712
Phone	520 232-9351
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024