Provider Demographics
NPI:1053573592
Name:CONSTRUYENDO CIRCULOS DE PAZ, INC.
Entity type:Organization
Organization Name:CONSTRUYENDO CIRCULOS DE PAZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:520-281-0579
Mailing Address - Street 1:1859 N GRAND AVE
Mailing Address - Street 2:SUITES 3 & 4
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-1386
Mailing Address - Country:US
Mailing Address - Phone:520-281-0579
Mailing Address - Fax:520-281-0493
Practice Address - Street 1:1859 N GRAND AVE
Practice Address - Street 2:SUITES 3 & 4
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-1386
Practice Address - Country:US
Practice Address - Phone:520-281-0579
Practice Address - Fax:520-281-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health