Individual provider Active NPI

Crisanta T Hannah, NONE

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1255478889
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
2721 Issued in AZ
Practice address
7151 W Valley Stream Drive
Tucson, AZ 85757-1422
Phone
(520) 888-0810
Fax
(520) 319-5491
NPI assigned
Jan 31, 2007
Last updated
Jan 18, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 2721 AZ Primary

Addresses

Primary practice location

7151 W Valley Stream Drive
Tucson, AZ 85757-1422

Mailing address

7151 W Valley Stream Drive
Tucson, AZ 85757-1422
Phone (520) 888-0810

Other identifiers 1

IdentifierTypeStateIssuer
921503OtherAZAHCCCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1255478889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7151 W VALLEY STREAM DRIVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857571422",
            "telephone_number": "520-888-0810",
            "fax_number": "520-319-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7151 W VALLEY STREAM DRIVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857571422",
            "telephone_number": "520-888-0810",
            "fax_number": "520-319-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "CRISANTA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "NONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "2721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "921503",
            "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 Jan 18, 2008; 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.