NPIMap

Organization Active NPI

Bethel

  • Community/Behavioral Health Agency
  • Tucson, AZ
National Provider Identifier
1104162288
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-4113 Issued in AZ
Legal business name
BETHEL
Practice address
9820 E Paseo San Bernardo
Tucson, AZ 85747-5022
Phone
(520) 891-0081
NPI assigned
Dec 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Mr. Koffi Seddo
Title
Administrator Provider
Phone
(520) 891-0081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-4113 AZ Primary

Addresses

Primary practice location

9820 E Paseo San Bernardo
Tucson, AZ 85747-5022

Mailing address

9820 E Paseo San Bernardo
Tucson, AZ 85747-5022

National Provider Directory

National Provider Directory
Tax ID family
Bethel2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1104162288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 E PASEO SAN BERNARDO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857475022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9820 E PASEO SAN BERNARDO",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857475022",
            "telephone_number": "520-891-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "SEDDO",
        "authorized_official_first_name": "KOFFI",
        "authorized_official_title_or_position": "ADMINISTRATOR PROVIDER",
        "authorized_official_telephone_number": "520-891-0081",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-4113",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 18, 2012; 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.