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Contact Information

CREOSOTE MENTAL HEALTH GROUP
4646 N SWAN RD STE 105
TUCSON, AZ85718-6715
 Phone: 520-307-6495
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
 

Addiction (Substance Use Disorder)

101YA0400X
 

Community Health Worker

172V00000X
 

Mental Health

101YM0800X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CREOSOTE MENTAL HEALTH GROUP

NPI # 1811509581
LBN Legal business name CREOSOTE MENTAL HEALTH GROUP
Authorized official CHAD MOSHER - (FOUNDER/DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/23/2020
Last updated 08/23/2020 - About 6 years ago
Identifiers
AZ Medicaid 1053801316
AZ Other 1053801316 GENERAL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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