CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC. (NPI# 1902092166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902092166 |
| Entity Type | Organization |
| Organization Name | CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC. |
| Other Organization Name | CHILDREN & ADOLESCENT SERVICES (CAS) |
| Practice Address |
160 W Fort Lowell Rd Tucson AZ 85705-3812 |
| Mailing Address |
127 S 5th Ave Tucson AZ 85701-2005 |
| Practice Telephone | 5203183266 |
| Practice Fax Number | 5203180821 |
| Mailing Telephone | 5203274505 |
| Mailing Fax Number | 5202021889 |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2008-02-15 |
| Authorized Official Name | MR. W MARK CLARK (CEO) |
| Authorized Official Telephone | 5203274505 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
BH-2093 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 278824 | 05 |
| Other Name | Type Code |
|---|---|
| Children & Adolescent Services (CAS) | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033319751 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 721 N 4th Ave, Tucson, AZ 85705-8446 | 2007-07-20 |
| 1497058150 | Codac Behavioral Health Services of Pima County, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2226 N Avenida El Capitan, Tucson, AZ 85705-5741 | 2010-12-17 |
| 1730208851 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 700 N 7th Ave, Tucson, AZ 85705-8307 | 2007-03-28 |
| 1356374953 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 1671 W Grant Rd, Tucson, AZ 85745-1433 | 2006-07-08 |
| 1447283148 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 4901 E 5th St, Tucson, AZ 85711-2203 | 2006-07-08 |
| Street Address |
160 W FORT LOWELL RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85705-3812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447422738 | Miroslava Laura Oviedo | Counselor | 160 W Fort Lowell Rd, Tucson, AZ 85705-3812 | 2008-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184257347 | John Matthew Gill, Od and Associates | Optometrist | 4500 N. Oracle Road, Suite 423, Tucson, AZ 85705 | 2020-02-17 |
| 1831730795 | El Rio Santa Cruz Neighborhood Health Center, Inc | Clinic/Center | 434 E University Blvd, Tucson, AZ 85705 | 2019-10-02 |
| 1730681685 | Casa De Los Ninos, Inc. | Community/Behavioral Health | 1120 N 5th Avenue, Tucson, AZ 85705 | 2018-03-07 |
| 1699275693 | Tzimari Sotelo | Nurse Practitioner | 941 N 11th Ave, Tucson, AZ 85705 | 2018-02-15 |
| 1679956502 | Dean Doan | Dentist | 2012 North Country Club Road, Suite E, Tucson, AZ 85705 | 2015-07-09 |
| 1437572955 | Home Is Where The Heart Is Senior Care | Home Health | 4541 N Old Romero Rd, #35, Tuscon, AZ 85705 | 2014-02-04 |
| 1932457553 | Pamela A Williamson | Registered Nurse | 698 E Wetmore Rd Ste 100, Tucson, AZ 85705 | 2012-08-29 |
| 1104136571 | Charles Tyler Upton | Counselor | 721 N. Fourth Ave, Tucson, AZ 85705 | 2010-10-19 |
| 1851629844 | Francisco Antonio Sanchez | Psychologist | 504 E. Speedway Blvd, Tucson, AZ 85705 | 2009-12-02 |
| 1235466145 | Maria Guadalupe Millan | Contractor | 870 W. Miracle Mile, La Paloma Family Services, Tucson, AZ 85705 | 2009-11-13 |
| Find all providers in zip 85705 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952685414 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1080 S 10th Ave, Tucson, AZ 85701-2907 | 2011-10-03 |
| 1063636165 | Arizona's Children Association | Clinic/Center | 3716 E. Columbia St., Tucson, AZ 85714 | 2007-04-12 |
| 1194808410 | Arizona's Children Association | Clinic/Center | 3618 E Pima St, Tucson, AZ 85716-3321 | 2006-10-23 |
| 1396828612 | Arizona's Children Association | Clinic/Center | 3716 E Columbia St, Tucson, AZ 85714-3414 | 2006-10-23 |
| 1699876532 | La Frontera Center, Inc. | Clinic/Center | 6401 S. Country Club, #157, Tucson, AZ 85706 | 2006-09-25 |
| 1003913385 | The Devereux Foundation | Clinic/Center | 6141 E Grant Rd, Tucson, AZ 85712-5829 | 2006-09-20 |
| 1205842705 | Pantano Behavioral Health Services, Inc. | Clinic/Center | 5055 E Broadway Blvd Ste C104, Tucson, AZ 85711-3641 | 2006-08-01 |
| 1699384040 | Thomas Reichenbacher, Md Pllc | Clinic/Center | 6650 N Oracle Rd Ste 110, Tucson, AZ 85704-5604 | 2020-07-30 |
| 1164044897 | Sun Ridge Psychotherapy Lc | Clinic/Center | 2948 E 8th St, Tucson, AZ 85716-5248 | 2020-05-15 |
| 1144785411 | Kristi Mcreynolds Pllc | Clinic/Center | 3801 N Campbell Ave Ste B, Tucson, AZ 85719-1448 | 2019-01-31 |
| 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.