NPIMap

Organization Active NPI

Mount Lemmon Healthcare LLC

  • Substance Abuse Rehabilitation Facility
  • Tucson, AZ
National Provider Identifier
1235878679
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MOUNT LEMMON HEALTHCARE LLC
Doing business as
Tucson Recovery Villa Maria
Practice address
4310 E Grant Rd
Tucson, AZ 85712-2607
Phone
(520) 323-9351
Fax
(520) 323-4087
NPI assigned
Jun 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4310 E Grant Rd
Tucson, AZ 85712-2607

Mailing address

4310 E Grant Rd
Tucson, AZ 85712-2607
Phone (520) 323-9351

Other names 1

  • Tucson Recovery Villa Maria Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mount Lemmon Healthcare LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1235878679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122607",
            "telephone_number": "520-323-9351",
            "fax_number": "520-323-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 E GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122607",
            "telephone_number": "520-323-9351",
            "fax_number": "520-323-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT LEMMON HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tucson Recovery Villa Maria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.