Provider Demographics
NPI:1124596911
Name:ETANO CONSULTING PLLC
Entity Type:Organization
Organization Name:ETANO CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:NICK
Authorized Official - Last Name:ONATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-325-3323
Mailing Address - Street 1:3956 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3315
Mailing Address - Country:US
Mailing Address - Phone:520-325-3323
Mailing Address - Fax:520-325-3379
Practice Address - Street 1:3956 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3315
Practice Address - Country:US
Practice Address - Phone:520-325-3323
Practice Address - Fax:520-325-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone