PROVIDENCE OF ARIZONA, INC. (NPI# 1003136748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003136748 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE OF ARIZONA, INC. |
| Practice Address |
630 N Craycroft Rd Tucson AZ 85711-1440 |
| Mailing Address |
620 N Craycroft Rd Tucson AZ 85711-1448 |
| Practice Telephone | 5207487108 |
| Practice Fax Number | 5207481458 |
| Mailing Telephone | 5207487108 |
| Mailing Fax Number | 5207481458 |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |
| Authorized Official Name | DAVE HEDGCOCK (EXECUTIVE VP) |
| Authorized Official Telephone | 5207487108 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE SERVICE CORPORATION |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588764427 | Providence of Arizona, Inc. | Clinic/Center | 3602 W Thomas Rd, Phoenix, AZ 85019-4442 | 2006-09-22 |
| Street Address |
630 N CRAYCROFT RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85711-1440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861522435 | United Cerebral Palsy of Southern Arizona, Inc | Home Health | 630 N Craycroft Rd, Tucson, AZ 85711-1405 | 2007-03-06 |
| 1285241869 | Maria Land | Behavioral Analyst | 630 N Craycroft Rd, Tucson, AZ 85711-1405 | 2020-09-28 |
| 1376172809 | Caitlin Carlon Welty | Behavioral Analyst | 630 N Craycroft Rd, Tucson, AZ 85711-1405 | 2020-04-06 |
| 1639717663 | Derrel Ann White | Behavioral Analyst | 630 N Craycroft Rd, Tucson, AZ 85711-1405 | 2019-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959951 | Ridgeline Practice | Counselor | 4625 N Broadway, Suite 105, Tucson, AZ 85711 | 2020-07-20 |
| 1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1063060093 | Sharese Ann Bailey | Counselor | 300 S Craycroft Rd, Tucson, AZ 85711 | 2019-09-03 |
| 1467940015 | Jin Zhang | Ophthalmology | 655 N Alvernon Way Ste 204, Tucson, AZ 85711 | 2018-04-30 |
| 1447779525 | Catherine Butler Hobart | Pharmacist | 535 North Wilmont Road, Suite 101, Tucson, AZ 85711 | 2017-09-11 |
| 1689196420 | Cope Community Services, Inc. | Case Management | 924 N Alvernon Way, Tucson, AZ 85711 | 2017-07-13 |
| 1124561477 | Regina Maendler | Behavioral Analyst | 630 N. Craycroft Rd, Tucson, AZ 85711 | 2016-11-18 |
| 1881140184 | Elleda Linsmeyer | Speech-Language Pathologist | St. Joesph's Hosptial, 350 N. Wilmont Rd., Tucson, AZ 85711 | 2016-08-28 |
| 1962856260 | Csl-tucson, LLC | Assisted Living Facility | 1020 N. Woodland Avenue, Tucson, AZ 85711 | 2016-04-22 |
| Find all providers in zip 85711 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013545144 | Tucson Counseling Associates, LLC | Clinic/Center | 125 E Mabel St, Tucson, AZ 85705-6654 | 2020-04-01 |
| 1043844756 | Restored Hope Counseling and Coaching Services | Clinic/Center | 4537 W Lord Redman Loop, Tucson, AZ 85741-4042 | 2020-03-03 |
| 1245876259 | Bamboo Wellness Pllc | Clinic/Center | 5151 E Broadway Blvd Ste 720, Tucson, AZ 85711-3783 | 2019-11-25 |
| 1245777481 | Sonora Behavioral Health Hospital, LLC | Clinic/Center | 2001 West Orange Grove Road, Suite 114, 112, 102, Tucson, AZ 85704 | 2017-01-26 |
| 1174997092 | Banner -- University Medicine Crisis Response Center LLC | Clinic/Center | 2802 E District St Fl 2, Tucson, AZ 85714-2081 | 2015-11-16 |
| 1295129823 | Terros, Inc. | Clinic/Center | 3385 N Campbell Ave, Tucson, AZ 85719-2306 | 2015-03-20 |
| 1518358530 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1600 N Country Club Rd, Tucson, AZ 85716-3119 | 2015-02-12 |
| 1053524348 | Pasadera Behavioral Health Network, Inc. | Clinic/Center | 2502 N. Dodge Blvd., Suite 190, Tucson, AZ 85716-2675 | 2007-05-07 |
| 1356482236 | Maple Star Nevada | Clinic/Center | 100 Washington St. Ste 350, Tucson, AZ 85711 | 2007-02-12 |
| 1659432763 | Adaptive Living Institute | Clinic/Center | 434 E 9th St, Tucson, AZ 85705-8580 | 2006-12-12 |
| Find all providers in TUCSON | ||||
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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.