BRENETTA HICKS-JONES (NPI# 1881961969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881961969 |
| Entity Type | Individual |
| Full Name | BRENETTA HICKS-JONES |
| Practice Address |
1318 S Coati Dr Tucson AZ 85713-1218 |
| Practice Telephone | 5206231022 |
| Mailing Telephone | 5206231022 |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2011-11-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH-3839 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ DEPT OF HEALTH SERVICES | BH-3938 | 01 |
| Street Address |
1318 S COATI DR |
| City | TUCSON |
| State | AZ |
| Zip Code | 85713-1218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851837744 | Carlette Jones | Respite Care | 1318 S Coati Dr, Tucson, AZ 85713-1218 | 2017-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679115489 | Eric James Mccracken | Nurse Practitioner | 1230 South Cherrybell Stravanue, Tucson, AZ 85713 | 2019-10-14 |
| 1336702448 | Julie Tomkins | Psychiatry & Neurology | Behavioral Health Pavilion, 2800 E Ajo Way, Tucson, AZ 85713 | 2019-04-16 |
| 1861958332 | El Rio Santa Cruz Neighborhood Health Center, Inc | Pharmacy | 1230 S Cherrybell Strav, Tucson, AZ 85713 | 2019-02-20 |
| 1164993002 | Lisa Ann Lindsay | Nurse Practitioner | 1230 S Cherrybell Stravenue, Tucson, AZ 85713 | 2018-12-17 |
| 1043701717 | Ramsha Saeed Rao | Student in an Organized Health Care Education/Training Program | Maria Jennings 2800 E. Ajo Way, Tucson, AZ 85713 | 2018-05-29 |
| 1215381736 | Nancy G Larison | Counselor | 504 W 29th Street, La Frontera Center, Inc., Tucson, AZ 85713 | 2016-04-21 |
| 1053791749 | Eric Lederer | Emergency Medicine | 3950 S. Country Club Rd, Ste. 200, Tucson, AZ 85713 | 2015-06-08 |
| 1942625025 | Eugene Randolph Shields | Obstetrics & Gynecology | 2315 W. Ocelot Drive, Tucson, AZ 85713 | 2014-02-26 |
| 1821361973 | Irene A Laventure | Nurse Practitioner | 2800 East Ajo Way, University of Arizona Medical Center - South Campus, Tucson, AZ 85713 | 2012-02-21 |
| 1386917417 | Caring Together,llc | Respite Care | 2957 E 24th Street, Tucson, AZ 85713 | 2012-02-21 |
| Find all providers in zip 85713 | ||||
| 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.