Tides Of Change Center Of Wellness
Community/Behavioral Health in Sierra Vista, AZ. Organization (NPI-2).
NPI number1376869321
StatusActive
Last updated in NPPESApr 15, 2010
Details
- NPI
- 1376869321
- Entity type
- Organization (NPI-2)
- Legal business name
- Tides Of Change Center Of Wellness
- Organization subpart
- No
- Enumeration date
- Apr 15, 2010
- Last updated
- Apr 15, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | LCSW10948 | AZ | Yes |
Practice location
1451 E Redrock DrSierra Vista, AZ 85650-8499
Phone 520-249-7650
Mailing address
1451 E Redrock DrSierra Vista, AZ 85650-8499
Phone 520-249-7650
Authorized official
Marianne S Valladares
President
5202497650
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