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SONORA BEHAVIORAL HEALTH HOSPITAL LLC NPI 1245777481


NPI Information

NPI: 1245777481
Provider Name: SONORA BEHAVIORAL HEALTH HOSPITAL, LLC

Other Name: SONORA BEHAVIORAL HEALTH - OUTPATIENT SERVICES

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 03D2133506

Address:
3130 E BROADWAY BLVD STE 196
TUCSON, AZ
ZIP 85716
Phone: (520) 399-8688
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SONORA BEHAVIORAL HEALTH HOSPITAL, LLC is a mental health (including community mental health center) clinic center in Tucson, AZ. SONORA BEHAVIORAL HEALTH HOSPITAL, LLC NPI is 1245777481. The provider is registered as an organization entity type.
The provider Other Name Is Sonora Behavioral Health - Outpatient Services.

The provider's business location address is:

3130 E BROADWAY BLVD STE 196
TUCSON, AZ
ZIP 85716-863
Phone: (520) 399-8688

The provider's authorized official is Brian P. Farley .
The authorized official title is Vp & Secretary and has the following contact phone number (615) 861-6000.

The CLIA number assigned to this NPI record is 03D2133506 - other - outpatient therapy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2017 and was last updated on 8/26/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1172145MEDICAIDARIZONA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.