NPIMap

Organization Active NPI

Lafrontera Center Inc.

  • Psychiatric Hospital Unit
  • Tucson, AZ
National Provider Identifier
1073614905
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
IFBH6469 Issued in AZ
Legal business name
LAFRONTERA CENTER INC.
Practice address
1601 E Apache Park PL
Tucson, AZ 85714-1775
Phone
(520) 746-0260
Fax
(520) 295-0834
NPI assigned
Sep 25, 2006
Last updated
Jul 12, 2024By the provider in NPPES
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
Ms. Kathy Wells
Title
VP/Coo
Phone
(520) 838-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X IFBH6469 AZ Primary

Addresses

Primary practice location

1601 E Apache Park PL
Tucson, AZ 85714-1775

Mailing address

504 W 29TH St
Tucson, AZ 85713-3353
Phone (520) 838-5600

Other identifiers 2

IdentifierTypeStateIssuer
589806MedicaidAZ
IFBH6469OtherAZBH 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

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1073614905",
    "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": "520-838-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E APACHE PARK PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857141775",
            "telephone_number": "520-746-0260",
            "fax_number": "520-295-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFRONTERA CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "520-838-5501",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "AZ",
            "license": "IFBH6469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589806",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BH LICENSE",
            "identifier": "IFBH6469",
            "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.