Provider Demographics
NPI:1821314568
Name:VERONICA HOUSE
Entity Type:Organization
Organization Name:VERONICA HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AKERE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-954-7133
Mailing Address - Street 1:2331 N TANQUE VERDE LOOP RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-9786
Mailing Address - Country:US
Mailing Address - Phone:520-954-7133
Mailing Address - Fax:
Practice Address - Street 1:2331 N TANQUE VERDE LOOP RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-9786
Practice Address - Country:US
Practice Address - Phone:520-954-7133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3947320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness