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EASTER SEALS BLAKE FOUNDATION NPI 1720232168


NPI Information

NPI: 1720232168
Provider Name: EASTER SEALS BLAKE FOUNDATION

Former Legal Business Name: BLAKE FOUNDATION

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
55 S 5TH ST
SIERRA VISTA, AZ
ZIP 85635
Phone: (520) 452-9784
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EASTER SEALS BLAKE FOUNDATION is a community behavioral health in Sierra Vista, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. EASTER SEALS BLAKE FOUNDATION NPI is 1720232168. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Blake Foundation.

The provider's business location address is:

55 S 5TH ST
SIERRA VISTA, AZ
ZIP 85635-857
Phone: (520) 452-9784

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 11/12/2008 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
1251B00000XCase ManagementNo
2251S00000XCommunity/Behavioral HealthOTC6905ARIZONAYes

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
1OTC6905OTHERARIZONAADHS LICENSE

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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