NPIMap

Organization Active NPI

Codac Health Recovery and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
National Provider Identifier
1992224455
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CODAC HEALTH RECOVERY AND WELLNESS
Practice address
380 E Fort Lowell Rd
Tucson, AZ 85705-3985
Phone
(520) 202-1796
Fax
(520) 792-4977
NPI assigned
Sep 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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

Authorized official

Name
Ms. Nora Navarro-Hernandez
Title
Senior Vice President
Phone
(520) 327-4505

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

380 E Fort Lowell Rd
Tucson, AZ 85705-3985

Mailing address

1650 E Fort Lowell Rd Ste 202
Tucson, AZ 85719-2378
Phone (520) 327-4505

Other identifiers 1

IdentifierTypeStateIssuer
000000MedicaidAZ

Other names 1

  • CODAC Medication Assisted Addiction Treatment Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Opioid treatment program
Medicare-enrolled since Jul 8, 2026

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426001693 AZ Part B Supplier - Clinic/Group Practice 6103813811 Receives reassigned benefits from 48 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505433600000",
    "number": "1992224455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E FORT LOWELL RD STE 202",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192378",
            "telephone_number": "520-327-4505",
            "fax_number": "520-202-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 E FORT LOWELL RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053985",
            "telephone_number": "520-202-1796",
            "fax_number": "520-792-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODAC HEALTH RECOVERY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A",
        "authorized_official_last_name": "NAVARRO-HERNANDEZ",
        "authorized_official_first_name": "NORA",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "520-327-4505",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CODAC Medication Assisted Addiction Treatment",
            "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 Sep 15, 2017; 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.