MR. JUAN M VASQUEZ


Address: 9264 S. Wilt Bank Road, Tucson, AZ 85735
Phone: 5204400630

MR. JUAN M VASQUEZ (NPI# 1912046566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912046566
Entity Type Individual
Full Name MR. JUAN M VASQUEZ
Credential NONE
Practice Address 9264 S. Wilt Bank Road
Tucson
AZ 85735
Mailing Address 9264 S. Wilt Bank Rd.
Tucson
AZ 85735
Practice Telephone 5204400630
Practice Fax Number 5203195491
Mailing Telephone 5204400630
Mailing Fax Number 5203195491
Enumeration Date 2007-02-06
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness 2433 AZ Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ BEHAVIORAL HEALTH NUMBER 2433 01

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Office Location

Street Address 9264 S. WILT BANK ROAD
City TUCSON
State AZ
Zip Code 85735

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1033756358 Native Music Coalition Residential Treatment Facility, Emotionally Disturbed Children 5150 S Crazy Cat Ln, Tucson, AZ 85735 2019-12-05
1295023976 Ana Lillian Aguilar Contractor 22405 W Bush Rd, Tucson, AZ 85735 2011-07-15
1558343012 Amy N Brunsvold Nurse Practitioner 15921 W Ajo Way, Tucson, AZ 85735 2005-11-18
1609354992 Angela M Robbins Nurse Practitioner 15921 W Ajo Hwy, Tucson, AZ 85735 2018-07-30
1366637456 Charlene A Gundry Nurse Practitioner 15921 W Ajo Way, Tucson, AZ 85735 2007-09-11
1619001492 Debra E Stamp Nurse Practitioner 15921 W Ajo Way, Tucson, AZ 85735 2007-03-15
1316999790 United Community Health Center - Maria Auxiliadora, Inc. Clinic/Center 15921 W Ajo Way, Tucson, AZ 85735 2006-05-16
1760633804 Edna Mercedes Canaletti Respite Care 7250 W Bopp Rd, Tucson, AZ 85735-1101 2008-10-07
1922488907 Pasadera Behavioral Health Network, Inc. Community/Behavioral Health 15390 W Ajo Hwy, Tucson, AZ 85735-2023 2015-06-04
1699125047 Community Intervention Assciates, Inc Community/Behavioral Health 15390 W Ajo Hwy, Tucson, AZ 85735-2023 2016-06-16
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

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1548817497 Christus Group Home Community Based Residential Treatment Facility, Mental Illness 6986 S Red Maids Dr, Tucson, AZ 85756-5100 2019-08-23
1255983037 Devereux Arizona Community Based Residential Treatment Facility, Mental Illness 2000 E Spring St, Tucson, AZ 85719-3428 2019-07-12
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1255881355 Codac Health, Recovery & Wellness, Inc. Community Based Residential Treatment Facility, Mental Illness 4801 E Helen St, Tucson, AZ 85712-4717 2016-10-12
1245787043 Community Partners Integrated Healthcare, Inc. Community Based Residential Treatment Facility, Mental Illness 2502 N Dodge Blvd Ste 190-west, Tucson, AZ 85716-2671 2016-09-08
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Competitor

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City TUCSON
Zip Code 85735

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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