NPI 1548338056

Laughing Moon Center

Organisation Exclusive Provider Organization Tucson, AZ

Practice location

Address: 4251 N Sanders Rd, Tucson, AZ 85743-7716
Phone: (520) 682-7886
Fax: (520) 616-7140

Authorised official

Name: Kirah Carolyn Clark
Title: Administrator
Phone: (520) 682-7886

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence BH2126 (AZ)

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Registry record

NPI: 1548338056
Entity type: Organization
NPI issued: 1 Dec 2006
Record last updated: 22 Aug 2020

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.