NPIMap

Organization Active NPI

La Frontera Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Tucson, AZ
National Provider Identifier
1063504199
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
BH-015 Issued in AZ
Legal business name
LA FRONTERA CENTER, INC.
Practice address
1900 W Speedway Blvd
Tucson, AZ 85745-2215
Phone
(520) 792-0591
Fax
(520) 882-5817
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Kathy Guzman Wells
Title
Evp/Coo
Phone
(520) 838-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X BH-015 AZ Primary

Addresses

Primary practice location

1900 W Speedway Blvd
Tucson, AZ 85745-2215

Mailing address

504 W 29TH St
Tucson, AZ 85713-3353
Phone (520) 884-9920

Other identifiers 2

IdentifierTypeStateIssuer
057837MedicaidAZ
BH015OtherAZBH LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115001022 AZ Part B Supplier - Clinic/Group Practice 0648171330 Receives reassigned benefits from 36 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
La Frontera Center Inc Dba la Frontera New Mexico30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

504 W 29th St
Tucson, AZ 85713
Phone (520) 838-5600

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1063504199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W 29TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857133353",
            "telephone_number": "520-884-9920",
            "fax_number": "520-792-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W SPEEDWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452215",
            "telephone_number": "520-792-0591",
            "fax_number": "520-882-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FRONTERA CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "GUZMAN",
        "authorized_official_title_or_position": "EVP/COO",
        "authorized_official_telephone_number": "520-838-5501"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057837",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BH LICENSE",
            "identifier": "BH015",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 12, 2024; 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.