SEQUELCARE OF ARIZONA (NPI# 1083115364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083115364 |
| Entity Type | Organization |
| Organization Name | SEQUELCARE OF ARIZONA |
| Practice Address |
8800 Marys Drive Flagstaff AZ 86004 |
| Mailing Address |
3170 Stillwater Drive Prescott AZ 86305 |
| Practice Telephone | 9285260997 |
| Practice Fax Number | 9285251151 |
| Mailing Telephone | 9287773280 |
| Mailing Fax Number | 9287171660 |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | WENDY RAZO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9287773280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH-3195 | AZ | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992326029 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 3001 N. Mountain View Rd, Prescott Valley, AZ 86314 | 2020-04-29 |
| 1679809636 | Sequelcare of Arizona | Community/Behavioral Health | 2020 S Mcclintock Drive Suite 105, Tempe, AZ 85282 | 2009-10-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SEQUELCARE OF ARIZONA LLC | 3170 Stillwater Dr, Prescott, AZ 86305-7151 |
| Street Address |
8800 MARYS DRIVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387805 | Michael Joseph Oxtoby | Counselor | 2625 N. King St., Flagstaff, AZ 86004 | 2020-05-08 |
| 1083264501 | Dazhoni Elizabeth Scott | Counselor | 1500 E. Cedar Avenue #26, 2110 N. East St Apt C, Flagstaff, AZ 86004 | 2019-09-17 |
| 1760948046 | Emily Bauerle | Social Worker | 3009 N West St, Flagstaff, AZ 86004 | 2019-02-12 |
| 1992295745 | Kaibab Behavioral Services, Pllc | Behavioral Analyst | 2323 E Greenlaw Lane, Suite 12a, Flagstaff, AZ 86004 | 2018-05-17 |
| 1710391081 | Janet Coleman | Hearing Instrument Specialist | 1851 E Butler Avenue, Flagstaff, AZ 86004 | 2014-06-16 |
| 1568703163 | Mercy Timoh | Pharmacist | 4255 E. Soliere Ave., Flagstaff, AZ 86004 | 2013-03-06 |
| 1053617217 | Scott Nichols | Veterinarian | 6122 Abineau Canyon Drive, Flagstaff, AZ 86004 | 2011-02-07 |
| 1366745218 | Karoline S. Mariano | Registered Nurse | 3480 East Route 66, Flagstaff, AZ 86004 | 2010-12-15 |
| 1912209719 | Payal Parekh | Pharmacist | 1500 E Cedar, Flagstaff, AZ 86004 | 2010-11-30 |
| 1316247885 | Ronald H Burr | Pharmacist | 4910 N Highway 89, Flagstaff, AZ 86004 | 2010-10-29 |
| Find all providers in zip 86004 | ||||
| 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 |
|---|---|---|---|---|
| 1932515087 | 2nd Chanzs | Community Based Residential Treatment Facility, Mental Illness | 1214 E Jen Dr, Flagstaff, AZ 86001-0757 | 2014-07-09 |
| 1760550156 | The Guidance Center | Community Based Residential Treatment Facility, Mental Illness | 1411 N Inverrary Way, Flagstaff, AZ 86004-7575 | 2006-12-01 |
| 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.