NPI 1003133067

Marana Teen Wellness Center

Organisation Federally Qualified Health Center (FQHC) Marana, AZ

Practice location

Address: 13644 N Sandario Rd, Marana, AZ 85653-8579
Phone: (520) 682-4730
Fax: (520) 682-4790
Mailing address: PO Box 188, Marana, AZ 85653-0188

Authorised official

Name: Dd Sande
Title: Credentialing Specialist
Phone: (520) 682-4560

Registered specialties

Federally Qualified Health Center (FQHC) Primary

Ambulatory Health Care Facilities Taxonomy 261QF0400X Licence OTC 0820 (AZ)

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Registry record

NPI: 1003133067
Entity type: Organization
NPI issued: 29 Apr 2010
Record last updated: 29 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.