NPIMap

Organization Active NPI

Sequelcare of Arizona, LLC

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1275860702
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-3441 Issued in AZ
Legal business name
SEQUELCARE OF ARIZONA, LLC
Practice address
450 West 5TH Place
Mesa, AZ 85201
Phone
(480) 429-4126
Fax
(480) 429-4126
NPI assigned
Nov 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Mrs. Nadine Ramirez
Title
Deputy Director
Phone
(928) 777-3280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-3441 AZ Primary

Addresses

Primary practice location

450 West 5TH Place
Mesa, AZ 85201

Mailing address

8603 E. Eastridge Drive
Ste. a
Prescott Valley, AZ 86314
Phone (928) 777-3280

Other identifiers 2

IdentifierTypeStateIssuer
476231MedicaidAZ
BH-3441OtherAZOBHL LICENSE

Other names 1

  • Tap Program Mesa Other name

National Provider Directory

National Provider Directory
Tax ID family
Brighter Heights Arizona LLC Dba Ocotillo Ranch15 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

450 W 5th Pl
Mesa, AZ 85201
Phone (480) 429-4126

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1275860702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8603 E. EASTRIDGE DRIVE",
            "address_2": "STE. A",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "86314",
            "telephone_number": "928-777-3280",
            "fax_number": "928-778-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WEST 5TH PLACE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85201",
            "telephone_number": "480-429-4126",
            "fax_number": "480-429-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUELCARE OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "928-777-3280",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-3441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "476231",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OBHL LICENSE",
            "identifier": "BH-3441",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tap Program Mesa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.