Provider Demographics
NPI:1447828223
Name:PASCUA YAQUI TRIBE
Entity type:Organization
Organization Name:PASCUA YAQUI TRIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COLLECTIONS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-879-6039
Mailing Address - Street 1:7490 S CAMINO DE OESTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-9308
Mailing Address - Country:US
Mailing Address - Phone:520-879-6039
Mailing Address - Fax:
Practice Address - Street 1:4728 W CALLE TETAKUSIM
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85757
Practice Address - Country:US
Practice Address - Phone:520-879-6110
Practice Address - Fax:520-883-1057
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PASCUA YAQUI TRIBE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-16
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility