NPIMap

Organization Active NPI

Pasadera Behavioral Health Network

Doing business as Pasadera Detox Overflow Unit

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Tucson, AZ
National Provider Identifier
1740550839
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
IFBH6795 Issued in AZ
Legal business name
PASADERA BEHAVIORAL HEALTH NETWORK
Doing business as
Pasadera Detox Overflow Unit
Practice address
2950 N. Dodge Blvd.
Tucson, AZ 85716-2012
Phone
(520) 628-4019
Fax
(520) 628-3158
NPI assigned
Jan 5, 2012
Last updated
Aug 13, 2015By the provider in NPPES
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
Chief Quality Management Officer
Phone
(520) 628-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X IFBH6795 AZ Primary

Addresses

Primary practice location

2950 N. Dodge Blvd.
Tucson, AZ 85716-2012

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
703481MedicaidAZ
IFBH6795OtherAZSTATE LICENSE

Other names 1

  • Pasadera Detox Overflow Unit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pasadera Behavioral Health Network10 organizations share this tax ID, including this one
Part of
Pasadera Behavioral Health Network

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": "1325721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1740550839",
    "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": "2950 N. DODGE BLVD.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857162012",
            "telephone_number": "520-628-4019",
            "fax_number": "520-628-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASADERA BEHAVIORAL HEALTH NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PASADERA BEHAVIORAL HEALTH NETWORK",
        "enumeration_date": "2012-01-05",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CHIEF QUALITY MANAGEMENT OFFICER",
        "authorized_official_telephone_number": "520-628-3400",
        "authorized_official_credential": "CPC, RMM, ICD10CT-CM"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "AZ",
            "license": "IFBH6795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "703481",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "IFBH6795",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasadera Detox Overflow Unit",
            "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.