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CODAC HEALTH RECOVERY & WELLNESS INC. NPI 1750797692


NPI Information

NPI: 1750797692
Provider Name: CODAC HEALTH, RECOVERY & WELLNESS, INC.

Doing Business As: CODAC AT ANDREW STREET

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
4758 E ANDREW ST
TUCSON, AZ
ZIP 85711
Phone: (520) 327-4505
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CODAC HEALTH, RECOVERY & WELLNESS, INC. 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. CODAC HEALTH, RECOVERY & WELLNESS, INC. NPI is 1750797692. The provider is registered as an organization entity type.
The provider Is Doing Business As Codac At Andrew Street.

The provider's business location address is:

4758 E ANDREW ST
TUCSON, AZ
ZIP 85711-427
Phone: (520) 327-4505
Fax: (520) 202-1889

The provider's authorized official is Dennis Regnier .
The authorized official title is Ceo and has the following contact phone number (520) 327-4505.

The enumeration date for this NPI number is 7/10/2014 and was last updated on 9/25/2015.


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 IllnessYes

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
1040601MEDICAIDARIZONA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.