Banner University Medicine Crisis Response Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BANNER UNIVERSITY MEDICINE CRISIS RESPONSE CENTER LLC

Practice address

2802 E District St
Tucson, AZ 85714-2081

Phone

(602) 253-5100

NPI assigned

Sep 18, 2015

Last updated

Dec 28, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

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

Authorized official

Name

Dennis Laraway

Title

Cfo

Phone

(602) 747-4000

Specialties & licenses 2

Addresses

Part of

Big Horn Family Med

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  dba Banner Hospice of Northern Colorado

  • Community Based Hospice Care Agency
  • Greeley, CO
  • NPI 1407409964

  Member Of

  NPD member

Practitioners 1

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.

• Dominique Montague, PA-C

  • Physician Assistant
  • Woodbury, NJ
  • NPI 1316233497
  NPD (past)

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1992174056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 E DISTRICT ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857142081",
            "telephone_number": "602-253-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER UNIVERSITY MEDICINE CRISIS RESPONSE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2015-09-18",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Banner Telehealth LLC
• Banner Umc Dpec
• Banner University Medical Center Phoenix Campus Liver Disease Services
• Banner University Medical Center Tucson
• Banner University Medical Center-Tucson
• Banner Urgent Care Services, LLC
• Banner Urgent Care Services, LLC
• Banner Urgent Care Services, LLC
• Banner Urgent Care Services, LLC
• Banner Urgent Care Services, LLC

• Adult Mental Health Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.