NPIMap

Organization Active NPI

Codac Health, Recovery & Wellness, Inc. Services Inc

  • Adult Mental Health Clinic/Center
  • Tucson, AZ
National Provider Identifier
1255658753
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
BH-3579 Issued in AZ
Legal business name
CODAC HEALTH, RECOVERY & WELLNESS, INC. SERVICES INC
Practice address
127 S 5TH Ave
Tucson, AZ 85701-2005
Phone
(520) 327-4505
Fax
(520) 202-1889
NPI assigned
Apr 23, 2010
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Mr. Dennis Regnier
Title
Ceo
Phone
(520) 327-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X BH-3579 AZ Primary

Addresses

Primary practice location

127 S 5TH Ave
Tucson, AZ 85701-2005

Mailing address

1650 E Fort Lowell Rd
Ste 202
Tucson, AZ 85719-2374
Phone (520) 327-4505

Other identifiers 1

IdentifierTypeStateIssuer
521279MedicaidAZ

Other names 1

  • CODAC Downtown Other name

National Provider Directory

National Provider Directory
Tax ID family
Codac Health Recovery13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1650 E Fort Lowell Rd
Ste 202
Tucson, AZ 85719
Phone (520) 202-1759

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1255658753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E FORT LOWELL RD",
            "address_2": "STE 202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192374",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S 5TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857012005",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODAC HEALTH, RECOVERY & WELLNESS, INC. SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "REGNIER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-327-4505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AZ",
            "license": "BH-3579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "521279",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CODAC Downtown",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 25, 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.