Creosote Mental Health Group

LBN: Creosote Mental Health Group
Creosote Mental Health Group is an health care organization with primary practice located at 4646 N Swan Rd Ste 105 , Tucson AZ 85718-6715. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Counseling, Other Service Providers / Community Health Worker. Behavioral Health & Social Service Providers / Counseling is the primary health care specialty. Creosote Mental Health Group can be contacted via phone (520) 307-6495, or through Mosher, Chad via phone (520) 307-6495.

Contact Information

Primary practice address
4646 N Swan Rd Ste 105 Tucson AZ 85718-6715
Phone: (520) 307-6495
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mosher, Chad PHD
Phone: (520) 307-6495

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1811509581
LBN Legal business name Creosote Mental Health Group
DBA Doing business as
Authorized official Mosher, Chad PHD
Entity Organization
Organization subpart 1 No
Enumeration date Aug 23rd, 2020
Last updated Aug 23rd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811509581 NPPES
Arizona Other 1053801316 GENERAL
Arizona MEDICAID 1053801316 GENERAL

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