NPIMap

Organization Active NPI

Treatment Assessment Screening Center, Inc

  • Community/Behavioral Health Agency
  • Flagstaff, AZ
National Provider Identifier
1801377270
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC9085 Issued in AZ
Legal business name
TREATMENT ASSESSMENT SCREENING CENTER, INC
Practice address
2314 N 4TH St
Flagstaff, AZ 86004-3709
Phone
(928) 526-5417
Fax
(928) 526-5615
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Authorized official

Name
Latrice Shannon Hickman, DO
Title
Chief Program Officer
Phone
(602) 254-7328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC9085 AZ Primary

Addresses

Primary practice location

2314 N 4TH St
Flagstaff, AZ 86004-3709

Mailing address

4016 N Black Canyon Hwy
Phoenix, AZ 85017-4730
Phone (602) 254-7328

Other identifiers 1

IdentifierTypeStateIssuer
OTC9085OtherAZARIZONA DEPARTMENT OF HEALTH SERVICES OUTPATIENT TREATMENT CENTER LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Tasc Inc8 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

2314 N 4th St
Flagstaff, AZ 86004
Phone (928) 526-0223

4016 N Black Canyon Hwy
Phoenix, AZ 85017
Phone (602) 254-7328

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1801377270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 N BLACK CANYON HWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850174730",
            "telephone_number": "602-254-7328",
            "fax_number": "602-255-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 N 4TH ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043709",
            "telephone_number": "928-526-5417",
            "fax_number": "928-526-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREATMENT ASSESSMENT SCREENING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "LATRICE",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "CHIEF PROGRAM OFFICER",
        "authorized_official_telephone_number": "602-254-7328",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC9085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPARTMENT OF HEALTH SERVICES OUTPATIENT TREATMENT CENTER LICENSE",
            "identifier": "OTC9085",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.