Provider Demographics
NPI:1740753045
Name:SEQUOIA SPRINGS TRAUMA HEALING CENTER INC
Entity Type:Organization
Organization Name:SEQUOIA SPRINGS TRAUMA HEALING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SHOSHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-838-0918
Mailing Address - Street 1:2055 N KOLB RD STE 121
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4099
Mailing Address - Country:US
Mailing Address - Phone:520-838-0918
Mailing Address - Fax:
Practice Address - Street 1:2055 N KOLB RD STE 121
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4099
Practice Address - Country:US
Practice Address - Phone:520-838-0918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty