Active NPI
Pasadera Behavioral Health Network, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tucson, AZ
National Provider Identifier
1053524348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- License
- OTC6597
- Legal business name
- PASADERA BEHAVIORAL HEALTH NETWORK, INC.
- Practice address
- 2502 N. Dodge Blvd.
Suite 190
Tucson, AZ 85716-2675 - Phone
- (520) 618-8600
- Fax
- (520) 617-1608
- NPI assigned
- May 7, 2007
- Organization subpart
- Yes
- Parent organization
- PASADERA BEHAVIORAL HEALTH NETWORK, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Oliver, CPC, RMM, ICD10CT-CM
- Title
- Chief Quality Management Officer
- Phone
- (520) 628-3400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | OTC6597 | AZ | Primary |
Addresses
Primary practice location
2502 N. Dodge Blvd.
Suite 190
Tucson, AZ 85716-2675
Mailing address
2700 S 8TH Ave
Tucson, AZ 85713-4730
Phone (520) 628-3400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTC6597 | Other | AZ | STATE LICENSE |
| 848952 | Medicaid | AZ |
Other names 1
- Pasadera Walk-In Clinic (SAMHC)
National Provider Directory
National Provider Directory- Part of
- Pasadera Behavioral Health Network Inc
Locations
2502 N Dodge Blvd
Ste 190
Tucson, AZ 85716
Phone (520) 617-0043
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Substance Abuse Rehabilitation Facility
- Tucson, AZ
- NPI 1609229574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1457395200000",
"number": "1053524348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 S 8TH AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857134730",
"telephone_number": "520-628-3400",
"fax_number": "520-628-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2502 N. DODGE BLVD.",
"address_2": "SUITE 190",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857162675",
"telephone_number": "520-618-8600",
"fax_number": "520-617-1608"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PASADERA BEHAVIORAL HEALTH NETWORK, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PASADERA BEHAVIORAL HEALTH NETWORK, INC.",
"enumeration_date": "2007-05-07",
"last_updated": "2016-03-08",
"status": "A",
"authorized_official_last_name": "OLIVER",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "CHIEF QUALITY MANAGEMENT OFFICER",
"authorized_official_telephone_number": "520-628-3400",
"authorized_official_credential": "CPC, RMM, ICD10CT-CM"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": "AZ",
"license": "OTC6597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "OTC6597",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "848952",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pasadera Walk-In Clinic (SAMHC)",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tucson, AZ
- Carmen Iris Parton
- Swetha Parvataneni, MD
- Pasadera Behavioral Health Network
- Pasadera Behavioral Health Network
- Pasadera Behavioral Health Network Dba Level II Detoxification
- Pasadera Behavioral Health Network, Inc.
- Pasadera Behavioral Health Network, Inc.
- Pasadera Behavioral Health Network, Inc.
- Pasadera Behavioral Health Network, Inc.
- Pasadera Behavioral Health Network, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.