CODAC HEALTH, RECOVERY & WELLNESS, INC. (NPI# 1174862007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174862007 |
Entity Type | Organization |
Organization Name | CODAC HEALTH, RECOVERY & WELLNESS, INC. |
Other Organization Name | CODAC AT ALVERNON |
Practice Address |
630 N Alvernon Way Ste 161 Tucson AZ 85711-1843 |
Mailing Address |
1650 E Fort Lowell Rd Ste 202 Tucson AZ 85719-2374 |
Practice Telephone | 5203189222 |
Practice Fax Number | 5203183443 |
Mailing Telephone | 5203274505 |
Mailing Fax Number | 5202021889 |
Enumeration Date | 2013-02-13 |
Last Update Date | 2015-09-25 |
Authorized Official Name | MR. DENNIS REGNIER (CEO) |
Authorized Official Telephone | 5203274505 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 805051 | 05 |
Other Name | Type Code |
---|---|
CODAC at Alvernon | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699226068 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2482 N Palo Verde Ave, Tucson, AZ 85716-2548 | 2016-10-20 |
1255881355 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4801 E Helen St, Tucson, AZ 85712-4717 | 2016-10-12 |
1518358530 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1600 N Country Club Rd, Tucson, AZ 85716-3119 | 2015-02-12 |
1750797692 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4758 E Andrew St, Tucson, AZ 85711-6427 | 2014-07-10 |
1952685414 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1080 S 10th Ave, Tucson, AZ 85701-2907 | 2011-10-03 |
1467475434 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 502 N Silverbell Rd, Tucson, AZ 85745-2626 | 2006-07-25 |
1730570102 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 101 W Irvington Rd, Office 3 A, Tucson, AZ 85714-3050 | 2015-02-06 |
1376931493 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2014-12-23 |
1801207642 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 3130 E Broadway Blvd, Tucson, AZ 85716-5863 | 2014-05-14 |
1235569328 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 2001 W Orange Grove Rd, Ste 416, Tucson, AZ 85704-1139 | 2013-11-26 |
Street Address |
630 N ALVERNON WAY STE 161 |
City | TUCSON |
State | AZ |
Zip Code | 85711-1843 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730189655 | James M Gillard | Emergency Medicine | 630 N Alvernon Way, Suite 250, Tucson, AZ 85711-1843 | 2005-07-21 |
1720568223 | Mary Elizabeth Hunter | Counselor | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2018-08-15 |
1770070732 | Andrew Ryan Dorsett | Registered Nurse | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2018-04-16 |
1417463316 | Wade Arden Vero Gage | Social Worker | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2017-12-14 |
1598201295 | Jessica Ganz | Nurse Practitioner | 630 N Alvernon Way, Suite 250, Tucson, AZ 85711-1843 | 2017-01-18 |
1396105797 | Smsj Tucson Holdings, LLC | Radiology | 630 N Alvernon Way, Suite 150, Tucson, AZ 85711-1843 | 2016-02-26 |
1336556596 | Ronald A. Kline, Md., PC | Surgery | 630 N Alvernon Way, Suite 180, Tucson, AZ 85711-1843 | 2014-07-18 |
1639416084 | Genoa Healthcare, LLC | Pharmacy | 630 N Alvernon Way, 1st Fl, Suite 161, Tucson, AZ 85711-1843 | 2013-01-04 |
1023308962 | El Rio Santa Cruz Neighborhood Health Center, Inc | Clinic/Center | 630 N Alvernon Way, Tucson, AZ 85711-1843 | 2011-04-12 |
1831491059 | Karen Lynn Modrzejewski | Registered Nurse | 630 N Alvernon Way, Tucson, AZ 85711 | 2010-11-19 |
Find all providers in the same location |
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 | 261QM0850X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adult Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093240020 | Cottonwood Tucson Outpatient Services | Clinic/Center | 4110 W Sweetwater Dr Bldg 16, Tucson, AZ 85745-9348 | 2017-04-27 |
1760916407 | Grace Home Assisted Living 1 | Clinic/Center | 2301 S Quail Hollow Dr, Tucson, AZ 85710-7986 | 2017-04-19 |
1730534405 | New Horizons Behavioral Health Services Inc | Clinic/Center | 5849 E 5th St, Tucson, AZ 85711-2403 | 2016-04-29 |
1205293487 | Neuropco LLC | Clinic/Center | 4061 E Via Del Vireo, Tucson, AZ 85718-3311 | 2016-01-20 |
1265806186 | Banner -- University Medicine Crisis Response Center LLC | Clinic/Center | 2802 E District St Fl 1, Tucson, AZ 85714-2081 | 2015-11-16 |
1457755183 | Barrabee Therapy LLC | Clinic/Center | 2299 W. Camino San Acacio, Tucson, AZ 85741-3696 | 2014-10-09 |
1487984720 | Desert Milagros, LLC | Clinic/Center | 3438 N. Country Club Road, Tucson, AZ 85716-1257 | 2010-01-09 |
1588814685 | Valerie M. Kading, Np, P.l.l.c | Clinic/Center | 6969 E Sunrise Dr, Suite 202, Tucson, AZ 85750-0720 | 2008-09-24 |
1770742959 | University Physicians Healthcare | Clinic/Center | 2800 E. Ajo Way, Tucson, AZ 85713-3204 | 2008-06-03 |
1033319751 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 721 N 4th Ave, Tucson, AZ 85705-8446 | 2007-07-20 |
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.