SEQUELCARE OF ARIZONA, LLC (NPI# 1780777540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780777540 |
| Entity Type | Organization |
| Organization Name | SEQUELCARE OF ARIZONA, LLC |
| Other Organization Name | PRESCOTT HOUSE |
| Practice Address |
4001 North Catherine Drive Prescott Valley AZ 86314 |
| Mailing Address |
8603 E. Eastridge Drive Suite A Prescott Valley AZ 86314 |
| Practice Telephone | 9287757118 |
| Mailing Telephone | 9287773280 |
| Mailing Fax Number | 9287171660 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-11-10 |
| Authorized Official Name | MR. LANCE JOHNSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9287773280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH-3650 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 560284 | 05 | |
| AZ | LIC # | BH-3650 | 01 |
| AZ | AHCCCS ID | 560284 | 01 |
| AZ | LIC # | BH4980 | 01 |
| AZ | LIC# | BH3650 | 01 |
| Other Name | Type Code |
|---|---|
| Prescott House | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275860702 | Sequelcare of Arizona, LLC | Community/Behavioral Health | 450 West 5th Place, Mesa, AZ 85201 | 2009-11-04 |
| 1003060534 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 14410 E. Blue Ridge Road, Dewey, AZ 86327 | 2008-11-11 |
| 1063663391 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3160 N. Pine View Drive, Prescott Valley, AZ 86314-2534 | 2008-10-06 |
| 1154443331 | Sequelcare of Arizona, LLC | Public Health or Welfare | 8603 E. Eastridge Drive, Ste. A, Prescott Valley, AZ 86314 | 2007-04-06 |
| 1376601914 | Sequelcare of Arizona, LLC | Counselor | 3170 Stillwater Dr., Prescott, AZ 86305 | 2006-12-05 |
| 1588740930 | Sequelcare of Arizona, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 9435 E Smoki Trail, Dewey, AZ 86327-6990 | 2006-10-28 |
| 1184712143 | Sequelcare of Arizona, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6070 N. Treadway Trail, Flagstaff, AZ 86004 | 2006-10-11 |
| 1770676439 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3240 Hualapai Mountain Road, Kingman, AZ 86401 | 2006-10-02 |
| 1124407390 | Sequelcare of Arizona, LLC | Behavioral Analyst | 8603 E Eastridge Rd, Prescott Valley, AZ 86314-8562 | 2015-05-21 |
| Street Address |
4001 NORTH CATHERINE DRIVE |
| City | PRESCOTT VALLEY |
| State | AZ |
| Zip Code | 86314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992326029 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 3001 N. Mountain View Rd, Prescott Valley, AZ 86314 | 2020-04-29 |
| 1124666516 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 5385 W Saddleback Drive, Prescott Valley, AZ 86314 | 2019-12-16 |
| 1912541558 | The Stateserv Companies, LLC | Durable Medical Equipment & Medical Supplies | 8926 E. Long Mesa Drive, Prescott Valley, AZ 86314 | 2019-11-06 |
| 1003398983 | Richard Telck | Pharmacist | 7720 E. Highway 69, Prescott Valley, AZ 86314 | 2018-09-06 |
| 1912493065 | Akdhc,llc | Internal Medicine | 7862 E Florentine Rd, Suite 120, Prescott Valley, AZ 86314 | 2018-07-02 |
| 1700377983 | Pronghorn Psychiatry | Clinic/Center | 5940 E. Copper Hill Dr, Suite E, Prescott Valley, AZ 86314 | 2018-05-23 |
| 1689185126 | Thumb Butte Urgent Care | Clinic/Center | 6496 East Highway 69, Prescott Valley, AZ 86314 | 2017-10-23 |
| 1740738046 | Janine Kauffmann | Pharmacist | 7720 East Highway 69, Prescott Valley, AZ 86314 | 2016-09-14 |
| 1528415650 | Nazcare, Inc. | Exclusive Provider Organization | 8200 E. Jacque Dr., Prescott Valley, AZ 86314 | 2016-05-18 |
| 1184087009 | William Beverly | Marriage & Family Therapist | 8603 E. Eastridge Dr., Ste A, Prescott Valley, AZ 86314 | 2016-03-29 |
| Find all providers in zip 86314 | ||||
| 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 |
|---|---|---|---|---|
| 1992326029 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 3001 N. Mountain View Rd, Prescott Valley, AZ 86314 | 2020-04-29 |
| 1063663391 | Sequelcare of Arizona, LLC | Community Based Residential Treatment Facility, Mental Illness | 3160 N. Pine View Drive, Prescott Valley, AZ 86314-2534 | 2008-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598253 | Pinnacle Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 45369 W Horse Mesa Rd, Maricopa, AZ 85139-9128 | 2020-11-03 |
| 1649878687 | Ayobami Noheem Agoro | Community Based Residential Treatment Facility, Mental Illness | 12362 W Joblanca Rd, Avondale, AZ 85323-3130 | 2020-10-13 |
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1144835968 | Jfox II LLC | Community Based Residential Treatment Facility, Mental Illness | 5327 E Enrose Cir, Mesa, AZ 85205-5489 | 2020-09-09 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1952913998 | Vema Corporation | Community Based Residential Treatment Facility, Mental Illness | 12701 N 79th Dr, Peoria, AZ 85381-9049 | 2020-08-20 |
| 1720698509 | Lyddia Getaweru | Community Based Residential Treatment Facility, Mental Illness | 2767 W Peggy Dr, Queen Creek, AZ 85142-6686 | 2020-08-05 |
| 1689284531 | Brain Solutions Pllc | Community Based Residential Treatment Facility, Mental Illness | 4555 S Maverick Ct, Gilbert, AZ 85297-9532 | 2020-08-05 |
| 1548879950 | C&j Care Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4418 W Darrel Rd, Laveen, AZ 85339-6222 | 2020-07-31 |
| 1295353019 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 2840 S Chaparral Blvd, Gilbert, AZ 85295-7675 | 2020-07-08 |
| Find all providers with the same taxonomy | ||||
| City | PRESCOTT VALLEY |
| Zip Code | 86314 |
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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.