NPIMap

Organization Active NPI

Easter Seals Blake Foundation

  • Community/Behavioral Health Agency
  • Tucson, AZ
National Provider Identifier
1760906440
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EASTER SEALS BLAKE FOUNDATION
Practice address
310 S Meyer Ave
Tucson, AZ 85701-2207
Phone
(520) 622-3933
Fax
(520) 670-9221
NPI assigned
Aug 3, 2017
Last updated
Sep 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
Marissa S Arendt
Title
Cfo
Phone
(520) 327-1529

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Mental Health Counselor 101YM0800X CSL8349 AZ
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

310 S Meyer Ave
Tucson, AZ 85701-2207

Mailing address

7750 E Broadway Blvd Ste A200
Tucson, AZ 85710-3901
Phone (520) 327-1529

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
Tax ID family
Easter Seals Blake Foundation8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

7750 E Broadway Blvd
Ste A200
Tucson, AZ 85710

Practitioners & affiliated clinicians

Practitioners 8

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": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1760906440",
    "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": "857103901",
            "telephone_number": "520-327-1529",
            "fax_number": "520-327-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S MEYER AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857012207",
            "telephone_number": "520-622-3933",
            "fax_number": "520-670-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS BLAKE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "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"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "CSL8349",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 1, 2023; 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.