Provider Demographics
NPI:1942779095
Name:CATHEXIS TUCSON, LLC
Entity Type:Organization
Organization Name:CATHEXIS TUCSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDOS MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-271-0628
Mailing Address - Street 1:6280 E PIMA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3074
Mailing Address - Country:US
Mailing Address - Phone:520-329-1250
Mailing Address - Fax:
Practice Address - Street 1:4750 N ORACLE RD STE 106
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1676
Practice Address - Country:US
Practice Address - Phone:520-329-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ036744Medicaid