NPIMap

Organization Active NPI

Arizona Training Program @ Coolidge

  • Intellectual Disabilities Intermediate Care Facility
  • Coolidge, AZ
National Provider Identifier
1346901956
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
ARIZONA TRAINING PROGRAM @ COOLIDGE
Practice address
2800 N. Hwy 87
Coolidge, AZ 85128
Phone
(520) 723-2600
Fax
(520) 723-7618
NPI assigned
Jan 5, 2022
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF ARIZONAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Zane Garcia Ramadan
Title
Assistant Director
Phone
(480) 490-6538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

2800 N. Hwy 87
Coolidge, AZ 85128

Mailing address

2800 N. Hwy 87
Coolidge, AZ 85128
Phone (520) 723-2600

Other names 1

  • 40 Oasis Court Other name

Medicare participation

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

NPI to CCN mapping 4

The Medicare certification numbers (CCNs) connected to NPI 1346901956. Details of each certification follow.

  • CCN 03G006 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details
  • CCN 03G011 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details
  • CCN 03G013 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details
  • CCN 03G014 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 03G006

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ATP - 40 SANDSTONE COURT
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 14, 1989
Last certification
Apr 22, 2025
Beds
20
Ownership / control type
State
Facility address
2800 N Hwy 87
Coolidge, AZ 85128

Intermediate care facility for individuals with intellectual disabilities certification: CCN 03G011

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ATP - 50 SANDSTONE COURT
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 5, 1991
Last certification
Jan 16, 2025
Beds
20
Ownership / control type
State
Facility address
2800 N Hwy 87
Coolidge, AZ 85128

Intermediate care facility for individuals with intellectual disabilities certification: CCN 03G013

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ATP - 30 SANDSTONE COURT
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 30, 1992
Last certification
Apr 4, 2023
Beds
20
Ownership / control type
State
Most recent change of ownership
Jun 1, 2006
Facility address
2800 N Hwy 87
Coolidge, AZ 85128

Intermediate care facility for individuals with intellectual disabilities certification: CCN 03G014

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ATP - 20 SANDSTONE COURT
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 1, 2001
Last certification
May 24, 2023
Beds
20
Ownership / control type
State
Facility address
2800 N Hwy 87
Coolidge, AZ 85128

National Provider Directory

National Provider Directory
Tax ID family
Southern Arizona Mental32 organizations share this tax ID, including this one
Part of
Southern Arizona Mental

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1346901956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N. HWY 87",
            "city": "COOLIDGE",
            "state": "AZ",
            "postal_code": "85128",
            "telephone_number": "520-723-2600",
            "fax_number": "520-723-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N. HWY 87",
            "city": "COOLIDGE",
            "state": "AZ",
            "postal_code": "85128",
            "telephone_number": "520-723-2600",
            "fax_number": "520-723-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA TRAINING PROGRAM @ COOLIDGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF ARIZONA",
        "enumeration_date": "2022-01-05",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "GARCIA RAMADAN",
        "authorized_official_first_name": "ZANE",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "480-490-6538"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "40 Oasis Court",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "40 Oasis Court",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coolidge, AZ

Sources for this page

Verify at the official NPI Registry.