Provider Demographics
NPI:1942921580
Name:TERROS, INC
Entity Type:Organization
Organization Name:TERROS, INC
Other - Org Name:TERROS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN TEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-685-6000
Mailing Address - Street 1:3003 N CENTRAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2929
Mailing Address - Country:US
Mailing Address - Phone:602-685-6000
Mailing Address - Fax:602-302-7925
Practice Address - Street 1:1750 S WOODLANDS VILLAGE BLVD STE 135
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-2699
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:928-679-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCSLG11936OtherOTC LICENSE