Tucson Residence Foundation Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

TUCSON RESIDENCE FOUNDATION INC.

Practice address

115 S Sherwood Village Dr
Tucson, AZ 85710-4142

Phone

(520) 790-9144

Fax

(520) 790-9290

NPI assigned

Jun 18, 2021

Last updated

Jun 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Bennetti

Title

Executive Director

Phone

(520) 790-9144

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1669041240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S SHERWOOD VILLAGE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857104142",
            "telephone_number": "520-790-9144",
            "fax_number": "520-790-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S SHERWOOD VILLAGE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857104142",
            "telephone_number": "520-790-9144",
            "fax_number": "520-790-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCSON RESIDENCE FOUNDATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "BENNETTI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "520-790-9144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017758",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.