NPIMap

Organization Active NPI

Sequel Tsi of Az, LLC

Doing business as Traditions St. Michaels

  • Adult Mental Health Clinic/Center
  • St. Michaels, AZ
National Provider Identifier
1609106335
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SEQUEL TSI OF AZ, LLC
Doing business as
Traditions St. Michaels
Practice address
Navajo Reservation
St. Michaels, AZ 86511
Phone
(928) 810-3707
Fax
(928) 810-3713
NPI assigned
Dec 31, 2009
Last updated
Dec 31, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SEQUELCARE OF AZ, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Chris Banken
Title
Executive Director
Phone
(602) 335-2095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

Navajo Reservation
St. Michaels, AZ 86511

Mailing address

PO Box 1093
St Michaels, AZ 86511-1093
Phone (928) 810-3707

Other names 1

  • Traditions St. Michaels Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sequel Tsi of Az LLC6 organizations share this tax ID, including this one
Part of
Brighter Heights Arizona LLC Dba Blue Ridge Manor

Other organizations with this tax ID 5

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": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1609106335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1093",
            "city": "ST MICHAELS",
            "state": "AZ",
            "postal_code": "865111093",
            "telephone_number": "928-810-3707",
            "fax_number": "928-810-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAJO RESERVATION",
            "city": "ST. MICHAELS",
            "state": "AZ",
            "postal_code": "86511",
            "telephone_number": "928-810-3707",
            "fax_number": "928-810-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL TSI OF AZ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUELCARE OF AZ, LLC",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "BANKEN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-335-2095"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Traditions St. Michaels",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St. Michaels, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.