INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC. NPI 1518055953

NPI Information

NPI: 1518055953
Provider Name: INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC.

Other Name: AIC SUNRISE

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization

CLIA Number: 03D2231946

Address:
8571 E TANQUE VERDE RD
TUCSON, AZ
ZIP 85749
Phone: (520) 721-1887
Get Directions

INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC. 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. INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC. NPI is 1518055953. The provider is registered as an organization entity type.
The provider Other Name Is Aic Sunrise.

The provider's business location address is:

8571 E TANQUE VERDE RD
TUCSON, AZ
ZIP 85749-917
Phone: (520) 721-1887
Fax: (520) 760-2481

The provider's authorized official is Rose Mary Lopez .
The authorized official title is President And Ceo and has the following contact phone number (520) 721-1887.

The CLIA number assigned to this NPI record is 03D2231946 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 10/9/2020.

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		BH1012	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	BH1618	OTHER	ARIZONA	STATE LICENSE
2	462573	MEDICAID	ARIZONA

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

NPI Synchronization or Removal

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