MARANA TEEN WELLNESS CENTER NPI 1104143411

NPI Information

  • NPI: 1104143411
  • Provider Name: MARANA TEEN WELLNESS CENTER
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Address: 12000 W EMIGH RD
    TUCSON, AZ
    ZIP 85743
  • Phone: (520) 682-9128

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NPI Details

MARANA TEEN WELLNESS CENTER is a federally qualified health center (fqhc) clinic center in Tucson, AZ. MARANA TEEN WELLNESS CENTER NPI is 1104143411. The provider is registered as an organization entity type.

The provider's business location address is:

12000 W EMIGH RD
TUCSON, AZ
ZIP 85743-696
Phone: (520) 682-9128
Fax: (520) 682-9136

The provider's authorized official is Dd Sande .
The authorized official title is Credentialing Specialist and has the following contact phone number (520) 682-4560.

The enumeration date for this NPI number is 4/26/2010 and was last updated on 4/26/2010.

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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)OTC0819ARIZONAYes

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: 11/21/2025

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