CODAC HEALTH, RECOVERY & WELLNESS, INC. (NPI# 1750797692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750797692 |
| Entity Type | Organization |
| Organization Name | CODAC HEALTH, RECOVERY & WELLNESS, INC. |
| Other Organization Name | CODAC AT ANDREW STREET |
| Practice Address |
4758 E Andrew St Tucson AZ 85711-6427 |
| Mailing Address |
1650 E Fort Lowell Rd Ste 202 Tucson AZ 85719-2374 |
| Practice Telephone | 5203274505 |
| Practice Fax Number | 5202021889 |
| Mailing Telephone | 5203274505 |
| Mailing Fax Number | 5202021889 |
| Enumeration Date | 2014-07-10 |
| 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 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 040601 | 05 |
| Other Name | Type Code |
|---|---|
| CODAC at Andrew Street | 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 |
| 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 |
| 1174862007 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 630 N Alvernon Way, Ste 161, Tucson, AZ 85711-1843 | 2013-02-13 |
| Street Address |
4758 E ANDREW ST |
| City | TUCSON |
| State | AZ |
| Zip Code | 85711-6427 |
| 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 | 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 |
|---|---|---|---|---|
| 1811519705 | Rhema Home | Community Based Residential Treatment Facility, Mental Illness | 5959 S Rowan Ct, Tucson, AZ 85706-0005 | 2020-05-13 |
| 1063059525 | Dream Builders of Arizona | Community Based Residential Treatment Facility, Mental Illness | 5115 W Sumter Dr, Tucson, AZ 85742-8247 | 2019-12-04 |
| 1548817497 | Christus Group Home | Community Based Residential Treatment Facility, Mental Illness | 6986 S Red Maids Dr, Tucson, AZ 85756-5100 | 2019-08-23 |
| 1255983037 | Devereux Arizona | Community Based Residential Treatment Facility, Mental Illness | 2000 E Spring St, Tucson, AZ 85719-3428 | 2019-07-12 |
| 1194280479 | Tender Loving Care Home LLC | Community Based Residential Treatment Facility, Mental Illness | 509 S Staunton Dr, Tucson, AZ 85710-6254 | 2019-01-31 |
| 1649755562 | Winam Behavioral Services | Community Based Residential Treatment Facility, Mental Illness | 534 S Kenyon Dr, Tucson, AZ 85710-4645 | 2018-09-26 |
| 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 |
| 1245787043 | Community Partners Integrated Healthcare, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2502 N Dodge Blvd Ste 190-west, Tucson, AZ 85716-2671 | 2016-09-08 |
| 1720439961 | Toate Ganago | Community Based Residential Treatment Facility, Mental Illness | 6781 S Aquiline Dr, Tucson, AZ 85756-8639 | 2016-06-29 |
| 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.