NPIMap

Organization Active NPI

Pasadera Behavioral Health Network

  • Substance Abuse Rehabilitation Facility
  • Tucson, AZ
National Provider Identifier
1700998002
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
BH-3687 Issued in AZ
Legal business name
PASADERA BEHAVIORAL HEALTH NETWORK
Practice address
302 W. Ventura St.
Tucson, AZ 85705-5478
Phone
(520) 620-0188
Fax
(520) 620-0197
NPI assigned
Aug 31, 2006
Organization subpart
Yes
Parent organization
PASADERA BEHAVIORAL HEALTH NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Authorized official

Name
Stephanie Oliver, CPC, RMM, ICD10CT-CM
Title
Director of QM
Phone
(520) 628-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X BH-3687 AZ Primary

Addresses

Primary practice location

302 W. Ventura St.
Tucson, AZ 85705-5478

Mailing address

2700 S 8TH Ave
Tucson, AZ 85713-4730
Phone (520) 628-3400

Other identifiers 2

IdentifierTypeStateIssuer
BH-3687OtherAZSTATE LICENSE
592776MedicaidAZ

Other names 1

  • Pasadera Serene Life Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pasadera Behavioral Health Network Inc10 organizations share this tax ID, including this one
Part of
Pasadera Behavioral Health Network Inc

Other organizations with this tax ID 9

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1700998002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S 8TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857134730",
            "telephone_number": "520-628-3400",
            "fax_number": "520-628-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W. VENTURA ST.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857055478",
            "telephone_number": "520-620-0188",
            "fax_number": "520-620-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASADERA BEHAVIORAL HEALTH NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PASADERA BEHAVIORAL HEALTH NETWORK",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR OF QM",
        "authorized_official_telephone_number": "520-628-3400",
        "authorized_official_credential": "CPC, RMM, ICD10CT-CM"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH-3687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "BH-3687",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "592776",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasadera Serene Life",
            "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 Aug 13, 2015; 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.