MIRASOL INC (NPI# 1407040553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407040553 |
| Entity Type | Organization |
| Organization Name | MIRASOL INC |
| Practice Address |
1515 E Kleindale Rd Tucson AZ 85719-1915 |
| Mailing Address |
2954 N Campbell Ave # 157 Tucson AZ 85719-2813 |
| Practice Telephone | 5205463200 |
| Practice Fax Number | 5205463205 |
| Mailing Telephone | 5205463200 |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2015-04-16 |
| Authorized Official Name | MS. JEANNE RUST (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5205463200 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | MIRASOL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | BH 4518 | AZ | Residential Treatment Facilities |
| Street Address |
1515 E KLEINDALE RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85719-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649813635 | Ishani Ravindra Deo | Psychologist | 1051 E Mabel St, Tucson, AZ 85719 | 2019-10-22 |
| 1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
| 1831652189 | Derek Allan Hatfield | Emergency Medicine | 1625 N Campbell Ave., Tucson, AZ 85719 | 2019-04-12 |
| 1053874305 | Travis Patrick Martin | Emergency Medicine | 1625 N. Campbell Ave, Tucson, AZ 85719 | 2019-04-12 |
| 1245793504 | Martin Cisneroz | Emergency Medicine | 1625 North Campbell Avenue, Tucson, AZ 85719 | 2019-04-12 |
| 1174086722 | Sarah Joy Ring | Emergency Medicine | 1625 N. Campbell Ave., Tucson, AZ 85719 | 2019-04-10 |
| 1790245520 | Akash M Doshi | Student in an Organized Health Care Education/Training Program | 3838 N Campbell Avenue, Bldg 2, Tuscon, AZ 85719 | 2019-03-20 |
| 1942773668 | Jeffery Roy Small | Massage Therapist | 3607 N Vine, Tucson, AZ 85719 | 2019-01-04 |
| 1114434180 | Elizabeth Irene Welch | Behavioral Analyst | 1430 E Fort Lowell Rd Ste 100, Tucson, AZ 85719 | 2017-12-29 |
| 1477076255 | Medavail Pharmacy Inc. | Pharmacy | 1430 E Fort Lowell Rd Ste 120, Tucson, AZ 85719 | 2017-07-24 |
| Find all providers in zip 85719 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669535720 | Mirasol, Inc. | Psychiatric Residential Treatment Facility | 10490 E Escalante Rd, Tucson, AZ 85730-5502 | 2006-12-19 |
| 1720177348 | La Frontera Center, Inc. | Psychiatric Residential Treatment Facility | 10845 N. Thornydale Road, Tucson, AZ 85742 | 2006-10-12 |
| 1023119955 | La Frontera Center, Inc. | Psychiatric Residential Treatment Facility | 1441 S. No Le Hace, Tucson, AZ 85745 | 2006-09-25 |
| 1255432183 | La Frontera Center, Inc. | Psychiatric Residential Treatment Facility | 10841 N Thornydale Road, Tucson, AZ 85742 | 2006-09-25 |
| 1346706306 | Impact Medical Group | Psychiatric Residential Treatment Facility | 870 W Miracle Mile, Tucson, AZ 85705-3708 | 2019-02-14 |
| 1154866853 | Bethel House | Psychiatric Residential Treatment Facility | 9820 E Paseo San Bernardo, Tucson, AZ 85747-5022 | 2017-01-04 |
| 1518299767 | Sierra Tucson, Inc. | Psychiatric Residential Treatment Facility | 39580 S Lago Del Oro Pkwy, Tucson, AZ 85739-1091 | 2010-02-12 |
| 1932334877 | Raymond William Novak | Psychiatric Residential Treatment Facility | 10500 E Tanque Verde Rd, Tucson, AZ 85749-8931 | 2009-05-21 |
| 1184814550 | Haven Sendero De Sonora, Inc. | Psychiatric Residential Treatment Facility | 2502 N Dodge Blvd, Suite 160, Tucson, AZ 85716-2671 | 2007-07-31 |
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| 1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
| 1073138673 | Hightower Behavioral Health Services | Psychiatric Residential Treatment Facility | 13206 W Crestvale Dr, Peoria, AZ 85383-5496 | 2020-06-10 |
| 1437773942 | Excellent Care LLC | Psychiatric Residential Treatment Facility | 14029 N 39th Ave, Phoenix, AZ 85053-5438 | 2020-06-01 |
| 1730701517 | Jezzob Behavioral Health LLC | Psychiatric Residential Treatment Facility | 4918 W Apollo Rd, Laveen, AZ 85339-6289 | 2020-05-14 |
| 1235750977 | Sagamar Behavioral Care Home, LLC | Psychiatric Residential Treatment Facility | 4444 N 13th Pl Apt 3, Phoenix, AZ 85014-4584 | 2020-05-05 |
| 1508492703 | Rehoboth LLC | Psychiatric Residential Treatment Facility | 41947 W Rosa Dr, Maricopa, AZ 85138-2550 | 2020-03-19 |
| 1851926661 | Cadens Health and Wellness LLC | Psychiatric Residential Treatment Facility | 5244 W Apollo Rd, Laveen, AZ 85339-6912 | 2020-03-12 |
| 1114552122 | Angel Heart Behavioral Health IIi LLC | Psychiatric Residential Treatment Facility | 9223 W Meadow Brook, 9223 W Meadow Brook Ave, Phoenix, AZ 85037-8503 | 2020-03-10 |
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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.