Provider Demographics
NPI:1821435470
Name:CAMINO REAL RECOVERY CENTER
Entity Type:Organization
Organization Name:CAMINO REAL RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LISAC
Authorized Official - Phone:520-790-5511
Mailing Address - Street 1:900 S CRAYCROFT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7113
Mailing Address - Country:US
Mailing Address - Phone:520-790-5511
Mailing Address - Fax:877-762-8149
Practice Address - Street 1:900 S CRAYCROFT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-7113
Practice Address - Country:US
Practice Address - Phone:520-790-5511
Practice Address - Fax:877-762-8149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty