SEQUELCARE OF ARIZONA, LLC (NPI# 1003060534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003060534 |
| Entity Type | Organization |
| Organization Name | SEQUELCARE OF ARIZONA, LLC |
| Other Organization Name | BLUE RIDGE |
| Practice Address |
14410 E. Blue Ridge Road Dewey AZ 86327 |
| Mailing Address |
8603 E. Eastridge Drive Ste. A Prescott Valley AZ 86314 |
| Practice Telephone | 9286328078 |
| Mailing Telephone | 9287773280 |
| Mailing Fax Number | 9287781252 |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2010-02-01 |
| Authorized Official Name | MRS. NADINE RAMIREZ (DEPUTY DIRECTOR) |
| Authorized Official Telephone | 9267773280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH-3197 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LICENSE NUMBER BH3197 | BH3 | 01 | |
| AZ | 824509 | 05 |
| Other Name | Type Code |
|---|---|
| Blue Ridge | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275860702 | Sequelcare of Arizona, LLC | Community/Behavioral Health | 450 West 5th Place, Mesa, AZ 85201 | 2009-11-04 |
| 1063663391 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3160 N. Pine View Drive, Prescott Valley, AZ 86314-2534 | 2008-10-06 |
| 1154443331 | Sequelcare of Arizona, LLC | Public Health or Welfare | 8603 E. Eastridge Drive, Ste. A, Prescott Valley, AZ 86314 | 2007-04-06 |
| 1376601914 | Sequelcare of Arizona, LLC | Counselor | 3170 Stillwater Dr., Prescott, AZ 86305 | 2006-12-05 |
| 1588740930 | Sequelcare of Arizona, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 9435 E Smoki Trail, Dewey, AZ 86327-6990 | 2006-10-28 |
| 1184712143 | Sequelcare of Arizona, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6070 N. Treadway Trail, Flagstaff, AZ 86004 | 2006-10-11 |
| 1780777540 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 4001 North Catherine Drive, Prescott Valley, AZ 86314 | 2006-10-02 |
| 1770676439 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3240 Hualapai Mountain Road, Kingman, AZ 86401 | 2006-10-02 |
| 1124407390 | Sequelcare of Arizona, LLC | Behavioral Analyst | 8603 E Eastridge Rd, Prescott Valley, AZ 86314-8562 | 2015-05-21 |
| Street Address |
14410 E. BLUE RIDGE ROAD |
| City | DEWEY |
| State | AZ |
| Zip Code | 86327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043791577 | Sarabeth Zurbano Roberto | Nurse Practitioner | 12075 Arizona 69, Dewey, AZ 86327 | 2018-08-23 |
| 1194224493 | Danielle Barbaro | Nurse Practitioner | 12075 Az - 69, Dewey, AZ 86327 | 2018-02-02 |
| 1437669504 | Caroline Bingham | Registered Nurse | 12075 Az State Route 69, Dewey, AZ 86327 | 2017-10-03 |
| 1245778323 | Copper Basin Healthcare, Inc. | Hospice Care, Community Based | 13207 E State Route 169 Ste A, Dewey, AZ 86327 | 2017-02-08 |
| 1346790748 | Holly Engelman | Nurse Practitioner | 150 Az-69 #1a, Dewey, AZ 86327 | 2016-10-10 |
| 1902262272 | Bradshaw Mountain Family Medicine LLC | Nurse Practitioner | 1163 E Old Chisholm Trail Suite C, Dewey, AZ 86327 | 2016-01-02 |
| 1255703229 | Clarence & Jeanne Kinsley, Dba | Respite Care | 17100 E. Lions Crossing Rd, Dewey, AZ 86327 | 2015-10-29 |
| 1740431196 | Andrew Gregory Bowers | Speech-Language Pathologist | 422 N. La Paz St., Dewey, AZ 86327 | 2008-10-03 |
| 1114090925 | Mingus Mountain Estate Residential Center Inc | Assisted Living Facility | 100 Dewey Road, Farrington Home, Dewey, AZ 86327 | 2006-11-17 |
| 1548349327 | Cindy Kay Noble | Specialist | 830 S Dewey Rd, Dewey, AZ 86327 | 2006-11-03 |
| Find all providers in zip 86327 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598253 | Pinnacle Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 45369 W Horse Mesa Rd, Maricopa, AZ 85139-9128 | 2020-11-03 |
| 1649878687 | Ayobami Noheem Agoro | Community Based Residential Treatment Facility, Mental Illness | 12362 W Joblanca Rd, Avondale, AZ 85323-3130 | 2020-10-13 |
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1144835968 | Jfox II LLC | Community Based Residential Treatment Facility, Mental Illness | 5327 E Enrose Cir, Mesa, AZ 85205-5489 | 2020-09-09 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1952913998 | Vema Corporation | Community Based Residential Treatment Facility, Mental Illness | 12701 N 79th Dr, Peoria, AZ 85381-9049 | 2020-08-20 |
| 1720698509 | Lyddia Getaweru | Community Based Residential Treatment Facility, Mental Illness | 2767 W Peggy Dr, Queen Creek, AZ 85142-6686 | 2020-08-05 |
| 1689284531 | Brain Solutions Pllc | Community Based Residential Treatment Facility, Mental Illness | 4555 S Maverick Ct, Gilbert, AZ 85297-9532 | 2020-08-05 |
| 1548879950 | C&j Care Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4418 W Darrel Rd, Laveen, AZ 85339-6222 | 2020-07-31 |
| 1295353019 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 2840 S Chaparral Blvd, Gilbert, AZ 85295-7675 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.