Provider Demographics
NPI:1629300702
Name:PIMA PREVENTION PARTNERSHIP
Entity Type:Organization
Organization Name:PIMA PREVENTION PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-791-2711
Mailing Address - Street 1:3130 E BROADWAY BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5863
Mailing Address - Country:US
Mailing Address - Phone:520-791-2711
Mailing Address - Fax:520-791-2202
Practice Address - Street 1:1346 N STONE AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7338
Practice Address - Country:US
Practice Address - Phone:520-326-2528
Practice Address - Fax:520-326-2527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ819641OtherARIZONA HEALTH CARE COST CONTAINMENT SYSTEM