SEQUEL TSI OF AZ, LLC (NPI# 1982934618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982934618 |
| Entity Type | Organization |
| Organization Name | SEQUEL TSI OF AZ, LLC |
| Other Organization Name | TRADITIONS KAYENTA |
| Practice Address |
Highway 163 Kayenta Mobile Home Park #8 Kayenta AZ 86033 |
| Practice Telephone | 9286973154 |
| Practice Fax Number | 9286973156 |
| Mailing Telephone | 9286973154 |
| Mailing Fax Number | 9286973156 |
| 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 Kayenta | 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 |
| 1790015428 | Sequel Tsi of Az, LLC | Clinic/Center | 75 S. Main St., Suite B, Kentucky Fried Chicken Comples, Tuba City, AZ 86045 | 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 |
| Street Address |
HIGHWAY 163 KAYENTA MOBILE HOME PARK #8 |
| City | KAYENTA |
| State | AZ |
| Zip Code | 86033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639135379 | Trc Four Corners Dialysis Clinics LLC | Clinic/Center | Highway 163, Kayenta, AZ 86033-9997 | 2006-04-21 |
| 1861863342 | Edward Kobialka Jr. | Pharmacist | Highway 163, Building Ka 2010, Kayenta, AZ 86033 | 2015-10-09 |
| 1720462195 | Carole Ashley | Social Worker | Highway 163, Bldg Ka-2010, Kayenta, AZ 86033 | 2015-07-16 |
| 1710382858 | Sugar Vinnette Young | Registered Nurse | Highway 163, Kayenta Health Center Bldg Ka-2010, Kayenta, AZ 86033 | 2014-10-31 |
| 1992043798 | Christopher Leroy Anderson | Pharmacist | Highway 163, Kayenta Service Center, Kayenta, AZ 86033 | 2013-01-29 |
| 1467789701 | Roxanne Natalie Thomas | Social Worker | Highway 163, Building Ka-2010, Kayenta, AZ 86033 | 2009-11-06 |
| 1235303991 | Jonathan James Lewis | Social Worker | Highway 163, Kayenta Health Center, Kayenta, AZ 86033 | 2008-04-14 |
| 1659309268 | Melanie Tarutani | Optometrist | Highway 163, Kayenta, AZ 86033 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048306 | Pauletta A Butterfly | Social Worker | Hwy. 160 Mp 394.3, Kayenta, AZ 86033 | 2019-11-20 |
| 1871143255 | Andrea Dawn Begay | Nurse's Aide | Us Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-09-17 |
| 1083264451 | Mavis Ann Bahe | Nurse's Aide | Kayenta Health Center, Us Hwy 160, Mp 394.3, Kayenta, AZ 86033 | 2019-09-17 |
| 1609420165 | Emily Ingram Nimon | Registered Nurse | Kayenta Health Center Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-08-01 |
| 1700439577 | Sherri A Verdon | Registered Nurse | Hwy 160 M.p 394.3, Kayenta, AZ 86033 | 2019-07-22 |
| 1447712104 | Cynthia Kaye Robbins | Registered Nurse | Us Highway 160 Mile Post 394.3, Kayenta, AZ 86033 | 2019-04-02 |
| 1871051052 | Brian Jason Miller | Registered Nurse | Hwy 160, Mile Post 394.3, Kayenta, AZ 86033 | 2019-03-07 |
| 1265915615 | Marissa Brooke Wall | Optometrist | 394.3 Us-160, Kayenta, AZ 86033 | 2018-09-12 |
| 1467952762 | Michael Ruddy | Pharmacist | Hwy 160 1/2 Mile South of Mile Post 394.3, Kayenta, AZ 86033 | 2018-02-14 |
| 1922516319 | Xavier Kelton Nelson | Spec/Tech, Pathology | Highway 160 Mp 394.3, Kayenta Health Center, Kayenta, AZ 86033 | 2018-01-19 |
| Find all providers in zip 86033 | ||||
| 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] |
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| 1073171153 | Heart Song Wellness LLC | Clinic/Center | 8617 W Union Hills Dr Ste 100, Peoria, AZ 85382-7001 | 2019-06-03 |
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| 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.