EASTER SEALS BLAKE FOUNDATION (NPI# 1548356207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548356207 |
Entity Type | Organization |
Organization Name | EASTER SEALS BLAKE FOUNDATION |
Practice Address |
5704 E. Grant Road Tucson AZ 85712 |
Practice Telephone | 5203271529 |
Practice Fax Number | 5203271836 |
Mailing Telephone | 5203271529 |
Mailing Fax Number | 5203271836 |
Enumeration Date | 2006-10-04 |
Last Update Date | 2009-10-13 |
Authorized Official Name | EMA KAMMEYER (C.E.O.) |
Authorized Official Telephone | 5203271529 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251B00000X | Case Management | Agencies | ||
N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
N | 385HR2065X |
Respite Care Specialization: Respite Care, Physical Disabilities, Child |
Respite Care Facility | ||
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053828160 | Easter Seals Blake Foundation | Community/Behavioral Health | 618 South Central Avenue, Safford, AZ 85546 | 2018-01-10 |
1548781487 | Easter Seals Blake Foundation | Community/Behavioral Health | 7750 E Broadway Blvd Ste A100, Tucson, AZ 85710-3901 | 2017-06-30 |
1376967323 | Easter Seals Blake Foundation | Community/Behavioral Health | 1060 S 5th Ave, Yuma, AZ 85364-3823 | 2014-02-11 |
1932530797 | Easter Seals Blake Foundation | Community/Behavioral Health | 7756 E Broadway Blvd, Ste. A-100, Tucson, AZ 85710 | 2013-12-04 |
1679847834 | Easter Seals Blake Foundation | Community/Behavioral Health | 320 S Convent Ave, Tucson, AZ 85701-2215 | 2012-03-05 |
1104079714 | Easter Seals Blake Foundation | Community/Behavioral Health | 1938 W Thatcher Blvd, Safford, AZ 85546-3318 | 2008-10-28 |
1760906440 | Easter Seals Blake Foundation | Counselor | 310 S Meyer Ave, Tucson, AZ 85701-2207 | 2017-08-03 |
1164875969 | Easter Seals Blake Foundation | Clinic/Center | 288 N Ironwood Dr Ste 115, Apache Junction, AZ 85120-3830 | 2016-07-15 |
1194156125 | Easter Seals Blake Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 5626 E 2nd St, Tucson, AZ 85711-1415 | 2013-12-02 |
1821429853 | Easter Seals Blake Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 5752 E Waverly St, Tucson, AZ 85712-3739 | 2013-12-02 |
Street Address |
5704 E. GRANT ROAD |
City | TUCSON |
State | AZ |
Zip Code | 85712 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871104950 | Nancy Rae Klug | Registered Nurse | 2380 N Ferguson Ave., Tucson, AZ 85712 | 2020-08-12 |
1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
1063031953 | Mehera Tiffanie Hormuz | Student in an Organized Health Care Education/Training Program | 5301 E. Grant Rd., Tucson, AZ 85712 | 2020-04-10 |
1770133282 | Elizabeth Nadeschzda Lowell | Nurse Practitioner | 4881 E Grant Road, Suite 101, Tucson, AZ 85712 | 2019-09-17 |
1174185649 | Pisa Asc Holdco LLC | Clinic/Center | 4741 E Camp Lowell Drive, Tucson, AZ 85712 | 2019-07-03 |
1548821838 | Painted Sky Healthcare, Inc. | Hospice Care, Community Based | 2980 N Swan Rd Ste 222, Tucson, AZ 85712 | 2019-06-26 |
1558925644 | Helen Jane Lyall | Registered Nurse | Tucson Medical Centre, 5301 E Grant Road, Tucson, AZ 85712 | 2019-04-24 |
1760953541 | Anna Marissa Ramirez | Nurse Practitioner | 5170 E Glenn St Ste 160, Tucson, AZ 85712 | 2018-12-05 |
1407343841 | Imran Ata Md Pllc | Internal Medicine | 3925 E Fort Lowell Rd Ste 105, Tucson, AZ 85712 | 2018-04-20 |
1003322926 | Millennium Acupuncture | Acupuncturist | 6161 E Pima St Tucson Az 85712, Apt 2074, Tucson, AZ 85712 | 2017-12-15 |
Find all providers in zip 85712 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952945370 | Natalie Miranda Contreras | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5717 S Southland Blvd Apt D, Tucson, AZ 85706-4241 | 2019-10-29 |
1023556347 | Rescare Arizona, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8040 E Eli St, Tucson, AZ 85710-5819 | 2017-02-07 |
1124566443 | Rescare Arizona, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3150 S Vaughn Dr, Tucson, AZ 85730-3612 | 2017-02-07 |
1851681118 | Origins Society and Global College | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2555 N Edith Blvd, Tucson, AZ 85716-2508 | 2011-04-07 |
1720225055 | Palm View Assisted Living, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11650 E Speedway Blvd, Tucson, AZ 85748-2016 | 2009-01-08 |
1043424278 | Danville Services of Arizona, L.L.C. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17 W Wetmore Rd, #201, Tucson, AZ 85705-1671 | 2007-05-09 |
1780895102 | Catholic Community Services of So. Az. Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 268 W Adams St, Tucson, AZ 85705-6534 | 2007-05-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356948954 | Forever Place LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4200 N Pebble Creek Pkwy Apt 2069, Goodyear, AZ 85395-9028 | 2020-10-06 |
1285245407 | Ams Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3058 E Nance St, Mesa, AZ 85213-1644 | 2020-08-11 |
1437768892 | Max Care Center LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2239 W Hasan Dr, Phoenix, AZ 85041-5312 | 2020-07-30 |
1265050876 | Arizona Alternative Support, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36379 W El Greco St, Maricopa, AZ 85138-5323 | 2020-07-09 |
1255957304 | Benchmark Valley LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7209 W Forest Grove Ave, Phoenix, AZ 85043-7303 | 2020-06-24 |
1265067052 | Benchmark Valley LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7321 S 15th Dr, Phoenix, AZ 85041-6932 | 2020-03-12 |
1083249874 | Benchmark Valley LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1506 E Irwin Ave, Phoenix, AZ 85042-5618 | 2020-03-12 |
1861024069 | New Roots Residency LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3139 W Carson Rd, Phoenix, AZ 85041-6342 | 2020-02-06 |
1972149078 | Serenitybehavioralhealth.llc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15202 N Flamenco Dr, Phoenix, AZ 85053-4872 | 2019-11-23 |
1386102788 | Huduma House, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6221 W Illini St, Phoenix, AZ 85043-1915 | 2019-03-05 |
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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.