NPIMap

Organization Active NPI

Sequel Tsi of Az, LLC

Doing business as Traditions Tuba City

  • Adult Mental Health Clinic/Center
  • Tuba City, AZ
National Provider Identifier
1790015428
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
SEQUEL TSI OF AZ, LLC
Doing business as
Traditions Tuba City
Practice address
75 S. Main St., Suite B
Kentucky Fried Chicken Comples
Tuba City, AZ 86045
Phone
(928) 283-6808
Fax
(928) 283-6848
NPI assigned
Dec 31, 2009
Last updated
Dec 31, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SEQUELCARE OF AZ, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Chris Banken
Title
Executive Director
Phone
(602) 335-2095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

75 S. Main St., Suite B
Kentucky Fried Chicken Comples
Tuba City, AZ 86045

Mailing address

PO Box 2257
Tuba City, AZ 86045-2257
Phone (928) 283-6808

Other names 1

  • Traditions Tuba City Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sequel Tsi of Az LLC6 organizations share this tax ID, including this one
Part of
Brighter Heights Arizona LLC Dba Blue Ridge Manor

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1790015428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860452257",
            "telephone_number": "928-283-6808",
            "fax_number": "928-283-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S. MAIN ST., SUITE B",
            "address_2": "KENTUCKY FRIED CHICKEN COMPLES",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "928-283-6808",
            "fax_number": "928-283-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL TSI OF AZ, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUELCARE OF AZ, LLC",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "BANKEN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-335-2095"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Traditions Tuba City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuba City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.