| NPI | 1750797692 |
|---|---|
| Doing Business As | CODAC AT ANDREW STREET |
| Entity Type | Organization |
| Authorized Contact | DENNIS REGNIER CEO 520-327-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2015-09-25 |