Provider Demographics
NPI:1487072351
Name:TERROS, INC.
Entity type:Organization
Organization Name:TERROS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
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 1:5801 N 51ST AVE STE 109
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-6057
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:602-930-0358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TERROS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-28
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4459324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ906404Medicaid
AZ906404Medicaid