PANTANO BEHAVIORAL HEALTH SERVICES, INC. (NPI# 1205842705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205842705 |
| Entity Type | Organization |
| Organization Name | PANTANO BEHAVIORAL HEALTH SERVICES, INC. |
| Practice Address |
5055 E Broadway Blvd Ste C104 Tucson AZ 85711-3641 |
| Practice Telephone | 5206239833 |
| Practice Fax Number | 5206239083 |
| Mailing Telephone | 5206239833 |
| Mailing Fax Number | 5206239083 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2012-11-14 |
| Authorized Official Name | MARISSA S ARENDT (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 5206239833 |
| Authorized Official Credential | CFE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
BH-2183 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID | 772576 | 01 |
| Street Address |
5055 E BROADWAY BLVD STE C104 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85711-3641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164085338 | Rebecca D Branstetter | Counselor | 5055 E Broadway Blvd Ste C104, Tucson, AZ 85711-3641 | 2019-04-15 |
| 1760932859 | Intermountain Centers for Human Development | Community/Behavioral Health | 5055 E Broadway Blvd Ste C104, Tucson, AZ 85711-3641 | 2016-10-12 |
| 1609245273 | Intermountain Health Center | Community/Behavioral Health | 5055 E Broadway Blvd Ste C104, Tucson, AZ 85711-3641 | 2015-09-24 |
| 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 | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952685414 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1080 S 10th Ave, Tucson, AZ 85701-2907 | 2011-10-03 |
| 1902092166 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 160 W Fort Lowell Rd, Tucson, AZ 85705-3812 | 2007-09-21 |
| 1063636165 | Arizona's Children Association | Clinic/Center | 3716 E. Columbia St., Tucson, AZ 85714 | 2007-04-12 |
| 1194808410 | Arizona's Children Association | Clinic/Center | 3618 E Pima St, Tucson, AZ 85716-3321 | 2006-10-23 |
| 1396828612 | Arizona's Children Association | Clinic/Center | 3716 E Columbia St, Tucson, AZ 85714-3414 | 2006-10-23 |
| 1699876532 | La Frontera Center, Inc. | Clinic/Center | 6401 S. Country Club, #157, Tucson, AZ 85706 | 2006-09-25 |
| 1003913385 | The Devereux Foundation | Clinic/Center | 6141 E Grant Rd, Tucson, AZ 85712-5829 | 2006-09-20 |
| 1699384040 | Thomas Reichenbacher, Md Pllc | Clinic/Center | 6650 N Oracle Rd Ste 110, Tucson, AZ 85704-5604 | 2020-07-30 |
| 1164044897 | Sun Ridge Psychotherapy Lc | Clinic/Center | 2948 E 8th St, Tucson, AZ 85716-5248 | 2020-05-15 |
| 1144785411 | Kristi Mcreynolds Pllc | Clinic/Center | 3801 N Campbell Ave Ste B, Tucson, AZ 85719-1448 | 2019-01-31 |
| 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.