NPIMap

Organization Active NPI

Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Sierra Vista, AZ
National Provider Identifier
1720232168
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC6905 Issued in AZ
Legal business name
EASTER SEALS BLAKE FOUNDATION
Practice address
500 N Garden Ave FL 3
Sierra Vista, AZ 85635-3813
Phone
(520) 452-9784
NPI assigned
Nov 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X OTC6905 AZ Primary

Addresses

Primary practice location

500 N Garden Ave FL 3
Sierra Vista, AZ 85635-3813

Mailing address

7750 E Broadway Blvd Ste A200
Tucson, AZ 85710-3903
Phone (520) 327-1529

Other practice location 1

55 S 5th St
Sierra Vista, AZ 85635-1857
Phone (520) 452-9784 ext. 11

Other identifiers 2

IdentifierTypeStateIssuer
OTC20576OtherAZADHS LICENSE
OTC6905OtherAZADHS LICENSE

Other names 1

  • Blake Foundation Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220217001894 AZ Part B Supplier - Clinic/Group Practice 9335302710 Receives reassigned benefits from 41 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nogales, AZ; Yuma, AZ; Tucson, AZ; Thatcher, AZ; Sierra Vista, AZ; Phoenix, AZ; Casa Grande, AZ

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

55 S 5th St
Ste A200
Sierra Vista, AZ 85635

500 N Garden Ave
Fl 3
Sierra Vista, AZ 85635

709 N Allred Ln
Ste 104105
Thatcher, AZ 85552

4653 E Pima St
Tucson, AZ 85712
Phone (520) 326-6182

6240 E Broadway Blvd Ste B
Tucson, AZ 85711
Phone (520) 207-7310

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1720232168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 E BROADWAY BLVD STE A200",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103903",
            "telephone_number": "520-327-1529",
            "fax_number": "520-207-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARDEN AVE FL 3",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353813",
            "telephone_number": "520-452-9784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 S 5th St",
            "address_purpose": "LOCATION",
            "city": "Sierra Vista",
            "state": "AZ",
            "postal_code": "856351857",
            "country_code": "US",
            "telephone_number": "520-452-9784 x11",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EASTER SEALS BLAKE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC6905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS LICENSE",
            "identifier": "OTC20576",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS LICENSE",
            "identifier": "OTC6905",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blake Foundation",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Blake Foundation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.