Provider Demographics
NPI:1528443066
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 HOFFMAN
Authorized Official - Middle Name:
Authorized Official - Last Name: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 1:8804 N 23RD AVE BUILDING A
Practice Address - Street 2:STE. A01 & A02
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4160
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:602-216-7040
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TERROS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-27
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ495827Medicaid
AZZ102678Medicare PIN