NPIMap

Organization Active NPI

Sequelcare of Arizona, LLC

  • Behavior Analyst
  • Prescott Valley, AZ
National Provider Identifier
1124407390
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
467011 Issued in AZ
Legal business name
SEQUELCARE OF ARIZONA, LLC
Practice address
8603 E Eastridge Rd
Prescott Valley, AZ 86314-8562
Phone
(928) 777-3280
NPI assigned
May 21, 2015
Last updated
May 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Tracie HirzNPI 1649659483
Title
HCTC Provider
Phone
(928) 777-3280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 467011 AZ Primary

Addresses

Primary practice location

8603 E Eastridge Rd
Prescott Valley, AZ 86314-8562

Mailing address

3656 Packsaddle Rd
Kingman, AZ 86401-6524

National Provider Directory

National Provider Directory
Tax ID family
Brighter Heights Arizona LLC Dba Blue Ridge Manor15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

8603 E Eastridge Rd
Prescott Vly, AZ 86314

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1124407390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 PACKSADDLE RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8603 E EASTRIDGE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148562",
            "telephone_number": "928-777-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUELCARE OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "HIRZ",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_title_or_position": "HCTC PROVIDER",
        "authorized_official_telephone_number": "928-777-3280"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "467011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.