NPIMap

Organization Active NPI

Sequelcare of Arizona

  • Community/Behavioral Health Agency
  • Tempe, AZ
National Provider Identifier
1679809636
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC8667 Issued in AZ
Legal business name
SEQUELCARE OF ARIZONA
Practice address
2020 S McClintock Drive Suite 105
Tempe, AZ 85282
Phone
(480) 284-7304
Fax
(480) 284-7616
NPI assigned
Oct 27, 2009
Last updated
Mar 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Authorized official

Name
Wendy Razo
Title
Executive Director
Phone
(928) 777-3280

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-3420 AZ
Community/Behavioral Health Agency 251S00000X OTC8667 AZ Primary

Addresses

Primary practice location

2020 S McClintock Drive Suite 105
Tempe, AZ 85282

Mailing address

3170 Stillwater Drive
Prescott, AZ 86305
Phone (928) 777-3280

Other identifiers 3

IdentifierTypeStateIssuer
BH-3420OtherAZAHCCCS
OTC8667OtherAZOUTPATIENT TREATMENT CENTER
476196MedicaidAZ

Other names 1

  • Tap Program Outpatient Clinic - Tempe Other name

National Provider Directory

National Provider Directory
Tax ID family
Brighter Heights Arizona LLC Dba Blue Ridge Manor15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

2020 S McClintock Dr
Ste 105
Tempe, AZ 85282
Phone (480) 284-7304

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1679809636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 STILLWATER DRIVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-777-3280",
            "fax_number": "928-717-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S MCCLINTOCK DRIVE SUITE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-284-7304",
            "fax_number": "480-284-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUELCARE OF ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "RAZO",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "928-777-3280"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-3420",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC8667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "BH-3420",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT TREATMENT CENTER",
            "identifier": "OTC8667",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "476196",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tap Program Outpatient Clinic - Tempe",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.