NPIMap

Organization Active NPI

Codac Behavioral Health Services of Pima County, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1497058150
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH3822 Issued in AZ
Legal business name
CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC.
Practice address
2226 N Avenida El Capitan
Tucson, AZ 85705-5741
Phone
(520) 327-4505
Fax
(520) 202-1889
NPI assigned
Dec 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Authorized official

Name
Mr. W. Mark Clark
Title
Ceo
Phone
(520) 327-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH3822 AZ Primary

Addresses

Primary practice location

2226 N Avenida El Capitan
Tucson, AZ 85705-5741

Mailing address

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

Other names 1

  • CODAC ARC Doing business as

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.

NPI Registry JSON

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1497058150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E FORT LOWELL RD",
            "address_2": "SUITE 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": "2226 N AVENIDA EL CAPITAN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857055741",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "W.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-327-4505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH3822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CODAC ARC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 1, 2011; 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.