Organization Active NPI

Pasadera Behavioral Health Network, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
National Provider Identifier
1053524348
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
OTC6597 Issued in AZ
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.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
OTC6597OtherAZSTATE LICENSE
848952MedicaidAZ

Other names 1

  • Pasadera Walk-In Clinic (SAMHC) Doing business as

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.

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

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.

Verify at the official NPI Registry.