Provider Demographics
NPI:1699881490
Name:PATTEN, DAVID ALLEN
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:PATTEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUENA VISTA RECOVERY CENTER
Mailing Address - Street 2:5151 E PIMA ST
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712
Mailing Address - Country:US
Mailing Address - Phone:806-800-6064
Mailing Address - Fax:
Practice Address - Street 1:BUENA VISTA RECOVERY CENTER
Practice Address - Street 2:5151 E PIMA ST
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85712
Practice Address - Country:US
Practice Address - Phone:806-800-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3939171W00000X
AZLAC20990101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLAC20990OtherAZBBHE LICENSE NUMBER
AZ1699881490OtherTHERAPEUTIC FOSTER CARE