Provider Demographics
NPI:1417716028
Name:SUMMER BREEZE HEALTH LLC
Entity Type:Organization
Organization Name:SUMMER BREEZE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:BALINDA-KAMANYIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-419-6960
Mailing Address - Street 1:3425 E GRANT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2840
Mailing Address - Country:US
Mailing Address - Phone:415-424-0419
Mailing Address - Fax:
Practice Address - Street 1:3425 E GRANT RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2840
Practice Address - Country:US
Practice Address - Phone:800-419-6960
Practice Address - Fax:800-419-6960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)