NPIMap

Organization Active NPI

Easter Seals Blake Foundation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1548356207
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
EASTER SEALS BLAKE FOUNDATION
Practice address
7750 E Broadway Blvd
Suite A200
Tucson, AZ 85710
Phone
(520) 327-1529
Fax
(520) 327-1836
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
Ms. Marissa S Arendt
Title
Cfo
Phone
(520) 327-1529

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary
Child Physical Disabilities Respite Care 385HR2065X

Addresses

Primary practice location

7750 E Broadway Blvd
Suite A200
Tucson, AZ 85710

Mailing address

7750 E Broadway Blvd
Suite A200
Tucson, AZ 85710
Phone (520) 327-1529

Other identifiers 1

IdentifierTypeStateIssuer
042622MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Blake Foundation8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

5704 E Grant Rd
Tucson, AZ 85712

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1548356207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 E BROADWAY BLVD",
            "address_2": "SUITE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-327-1529",
            "fax_number": "520-327-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 E BROADWAY BLVD",
            "address_2": "SUITE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-327-1529",
            "fax_number": "520-327-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS BLAKE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "ARENDT",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "520-327-1529",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042622",
            "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 Sep 1, 2023; 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.