Mirasol, INC.
Psychiatric Residential Treatment Facility in Tucson, AZ. Organization (NPI-2).
Details
- NPI
- 1669535720
- Entity type
- Organization (NPI-2)
- Legal business name
- Mirasol, INC.
- Organization subpart
- No
- Enumeration date
- Dec 19, 2006
- Last updated
- Apr 15, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 323P00000X | Psychiatric Residential Treatment Facility | BH 4529 | AZ | Yes |
Practice location
10490 E Escalante RdTucson, AZ 85730-5502
Phone 520-546-3200 · Fax 520-546-3205
Mailing address
2954 N Campbell Ave # 157Tucson, AZ 85719-2813
Phone 520-546-3200 · Fax 520-546-3205
Authorized official
Jeanne Rust
Executive Director
5205463200
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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