Provider Demographics
NPI:1649646787
Name:CORNERSTONE BEHAVIORAL HEALTH TUCSON
Entity type:Organization
Organization Name:CORNERSTONE BEHAVIORAL HEALTH TUCSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7688
Mailing Address - Street 1:2200 ROSS AVE STE 5400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7918
Mailing Address - Country:US
Mailing Address - Phone:469-621-6700
Mailing Address - Fax:469-621-6678
Practice Address - Street 1:1400 N WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4498
Practice Address - Country:US
Practice Address - Phone:520-222-8268
Practice Address - Fax:520-282-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-12
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital