CODAC HEALTH, RECOVERY & WELLNESS, INC. (NPI# 1952685414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952685414 |
| Entity Type | Organization |
| Organization Name | CODAC HEALTH, RECOVERY & WELLNESS, INC. |
| Other Organization Name | CODAC SANTA ROSA |
| Practice Address |
1080 S 10th Ave Tucson AZ 85701-2907 |
| Mailing Address |
1650 E Fort Lowell Rd Suite 202 Tucson AZ 85719-2374 |
| Practice Telephone | 5206233533 |
| Practice Fax Number | 5205946345 |
| Mailing Telephone | 5203274505 |
| Mailing Fax Number | 5202021889 |
| Enumeration Date | 2011-10-03 |
| 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 | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
BH-3922 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 653946 | 05 |
| Other Name | Type Code |
|---|---|
| CODAC Santa Rosa | 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 |
| 1750797692 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4758 E Andrew St, Tucson, AZ 85711-6427 | 2014-07-10 |
| 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 |
1080 S 10TH AVE |
| City | TUCSON |
| State | AZ |
| Zip Code | 85701-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962786343 | Mary Elizabeth Kent | Counselor | 1080 S 10th Ave, Tucson, AZ 85701-2907 | 2011-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396203089 | Marisa Riddle | Registered Nurse | 220 W 6th Street, Tucson, AZ 85701 | 2019-03-12 |
| 1023593126 | Catherine Lee | Pharmacist | 220 W 6th Street Room B113, Tucson, AZ 85701 | 2018-09-25 |
| 1730425455 | Jan Courtney | Counselor | 85 W Franklin, Cope Community Services, Tucson, AZ 85701 | 2012-12-28 |
| 1750641569 | Christine A Widener | Social Worker | 240 N Court Ave, Tucson, AZ 85701 | 2012-05-25 |
| 1336337039 | Gerard Anthony Scarano | Psychologist | 10 E 10th St, Tucson, AZ 85701 | 2007-10-09 |
| 1922166107 | Coyote Task Force | Community/Behavioral Health | 66 E Pennington, Tucson, AZ 85701 | 2006-12-04 |
| 1407928575 | Community Provider of Enrichment Services, Inc. | Community/Behavioral Health | 355 W 24th St, Tucson, AZ 85701 | 2006-11-14 |
| 1164510731 | G. Lynn Bonner | Counselor | 325 W. Franklin St., Ste 117, Tucson, AZ 85701 | 2006-10-10 |
| 1548361470 | La Frontera Center, Inc. | Clinic/Center | 260 S. Scott, Tucson, AZ 85701 | 2006-09-25 |
| 1356317077 | Linda Kapinos | Nurse Practitioner | 101 South Stone Avenue, Cope Community Services, Inc., Tucson, AZ 85701 | 2006-02-23 |
| Find all providers in zip 85701 | ||||
| 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 |
|---|---|---|---|---|
| 1902092166 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 160 W Fort Lowell Rd, Tucson, AZ 85705-3812 | 2007-09-21 |
| 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.