SEQUEL TSI OF AZ, LLC (NPI# 1790015428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790015428 |
| Entity Type | Organization |
| Organization Name | SEQUEL TSI OF AZ, LLC |
| Other Organization Name | TRADITIONS TUBA CITY |
| Practice Address |
75 S. Main St., Suite B Kentucky Fried Chicken Comples Tuba City AZ 86045 |
| Mailing Address |
Po Box 2257 Tuba City AZ 86045-2257 |
| Practice Telephone | 9282836808 |
| Practice Fax Number | 9282836848 |
| Mailing Telephone | 9282836808 |
| Mailing Fax Number | 9282836848 |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |
| Authorized Official Name | CHRIS BANKEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6023352095 |
| Is Organization Subpart | Y |
| Parent Organization Name | SEQUELCARE OF AZ, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Traditions Tuba City | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891025524 | Sequel Tsi of Az, LLC | Clinic/Center | 1109 S. Chief Ave., White Mountain Apache Motel., Whiteriver, AZ 85941 | 2009-12-31 |
| 1609106335 | Sequel Tsi of Az, LLC | Clinic/Center | Navajo Reservation, St. Michaels, AZ 86511 | 2009-12-31 |
| 1518297241 | Sequel Tsi of Az, LLC | Clinic/Center | Navajo Route 7, Westside Trinity Presbyterian Church, Chinle, AZ 86503 | 2009-12-31 |
| 1982934618 | Sequel Tsi of Az, LLC | Clinic/Center | Highway 163, Kayenta Mobile Home Park #8, Kayenta, AZ 86033 | 2009-12-31 |
| Street Address |
75 S. MAIN ST., SUITE B KENTUCKY FRIED CHICKEN COMPLES |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609950815 | Vista Care, LLC | Clinic/Center | 2027 N Spruce Street, Tuba City, AZ 86045 | 2006-10-24 |
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| 1497372908 | A Path of Resilience - Aprbhs - Rose House - LLC | Clinic/Center | 2258 W Wayland Rd, Phoenix, AZ 85041-3753 | 2020-06-30 |
| 1083237630 | The Heart Program | Clinic/Center | 4041 E Flower St, Phoenix, AZ 85018-6433 | 2020-05-18 |
| 1316569056 | Desert Heart Counseling Corp | Clinic/Center | 1536 E Maryland Ave Ste B300, Phoenix, AZ 85014-1475 | 2020-05-16 |
| 1922638055 | Lotus Health Arizona | Clinic/Center | 2600 E Southern Ave Ste I3, Tempe, AZ 85282-7738 | 2020-01-16 |
| 1689218687 | Devine Momentum Phoenix | Clinic/Center | 15342 W Turney Ave, Goodyear, AZ 85395-6323 | 2019-11-01 |
| 1588212195 | Tamarria Denga | Clinic/Center | 10000 N 31st Ave Ste D411, Phoenix, AZ 85051-1358 | 2019-08-27 |
| 1932768975 | Evolve Counseling & Behavioral Health Services | Clinic/Center | 1206 E Warner Rd # 203, Gilbert, AZ 85296-3132 | 2019-06-12 |
| 1073171153 | Heart Song Wellness LLC | Clinic/Center | 8617 W Union Hills Dr Ste 100, Peoria, AZ 85382-7001 | 2019-06-03 |
| 1659936680 | Sedona Family Counseling | Clinic/Center | 130 Castle Rock Rd Unit 65, Sedona, AZ 86351-8876 | 2019-05-06 |
| 1043778756 | Aye Wellness, Pllc | Clinic/Center | 2406 S 24th St Ste E100, Phoenix, AZ 85034-6801 | 2019-03-12 |
| Find all providers with the same taxonomy | ||||
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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.