Organization Name: | THE DEVEREUX ARIZONA |
NPI Number: | 1699105445 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LANE MARTIN-BARKER (EXECUTIVE DIRECTOR) |
Mailing Address: | 2502 N Dodge Blvd #120 Tucson |
State: | AZ US |
Postal Code: | 857162671 |
Phone Number: | 4809982920 |
Fax Number: | |
NPI Enumeration Date: | 11/14/2013 |
NPI Last Update Date: | 05/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |