NPIMap

Organization Active NPI

Codac Health Recovery and Wellness

  • Community/Behavioral Health Agency
  • Tucson, AZ
National Provider Identifier
1033156567
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CODAC HEALTH RECOVERY AND WELLNESS
Practice address
4585 E Speedway Blvd
Tucson, AZ 85712
Phone
(520) 327-4505
Fax
(520) 202-1889
NPI assigned
Jun 1, 2006
Last updated
Apr 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dennis Regnier
Title
Ceo
Phone
(520) 327-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4585 E Speedway Blvd
Tucson, AZ 85712

Mailing address

Dept 880460
PO Box 29650
Phoenix, AZ 85038
Phone (520) 327-4505

Other identifiers 1

IdentifierTypeStateIssuer
214427MedicaidAZ

Other names 1

  • CODAC Administration Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426001693 AZ Part B Supplier - Clinic/Group Practice 6103813811 Receives reassigned benefits from 48 practitioners
23 other NPIs on this enrollment
Practice locations: Tucson, AZ

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Codac Behavioral Health Services Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

101 W Irvington Rd
Ofc 3A
Tucson, AZ 85714

1650 E Fort Lowell Rd
Tucson, AZ 85719
Phone (529) 327-4505

2720 S 6th Ave
Tucson, AZ 85713
Phone (520) 475-5418

Interoperability endpoints

  • Direct secure messaging: adam.case@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: arturo.ventura@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: catherine.laughlin@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: chang.lee@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: clayton.black@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: daniel.barden@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: daniel.murphy@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: daniela.losey@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: eddie.ornelas@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: emmanuel.fon@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: eris.norvilus@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: jami.vanbrocklin@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: jamie.young@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: jaymien.condoy@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: justine.goville@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: karen.reynolds@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: kathryn.clarke@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: larry.onate@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: lee.pinkerton@mmcodachrw.contexture.medalliesmail.com
  • Direct secure messaging: lori.solis@mmcodachrw.contexture.medalliesmail.com

Practitioners & affiliated clinicians

Practitioners 73

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 73

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1033156567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 880460",
            "address_2": "PO BOX 29650",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85038",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 E SPEEDWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODAC HEALTH RECOVERY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "REGNIER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-327-4505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214427",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CODAC Administration",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.