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EASTER SEALS BLAKE FOUNDATION NPI 1629409537


NPI Information

NPI: 1629409537
Provider Name: EASTER SEALS BLAKE FOUNDATION

Other Name: SAGUARO HOUSE

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
5120 E ALBERTA DR
TUCSON, AZ
ZIP 85711
Phone: (520) 514-7480
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EASTER SEALS BLAKE FOUNDATION is a community based residential treatment facility mental illness in Tucson, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. EASTER SEALS BLAKE FOUNDATION NPI is 1629409537. The provider is registered as an organization entity type.
The provider Other Name Is Saguaro House.

The provider's business location address is:

5120 E ALBERTA DR
TUCSON, AZ
ZIP 85711-119
Phone: (520) 514-7480

The provider's authorized official is Marissa S Arendt .
The authorized official title is Cfo and has the following contact phone number (520) 327-1529.

The enumeration date for this NPI number is 12/2/2013 and was last updated on 9/1/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessBH-4426ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1BH4426OTHERARIZONAAZ BEHAVIORAL HEALTH RESIDENTIAL FACILITY LICENSE
2881657OTHERARIZONAAHCCCS PROVIDER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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