CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC. (NPI# 1447283148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447283148 |
| Entity Type | Organization |
| Organization Name | CODAC BEHAVIORAL HEALTH SERVICES OF PIMA COUNTY, INC. |
| Other Organization Name | CODAC EAST |
| Practice Address |
4901 E 5th St Tucson AZ 85711-2203 |
| Mailing Address |
127 S 5th Ave Tucson AZ 85701-2005 |
| Practice Telephone | 5203274505 |
| Practice Fax Number | 5202021889 |
| Mailing Telephone | 5203274505 |
| Mailing Fax Number | 5202021889 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2008-02-15 |
| Authorized Official Name | MR. W. MARK CLARK (CEO) |
| Authorized Official Telephone | 5203274505 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
BH-1632 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 343872 | 05 |
| Other Name | Type Code |
|---|---|
| CODAC East | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902092166 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 160 W Fort Lowell Rd, Tucson, AZ 85705-3812 | 2007-09-21 |
| 1033319751 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 721 N 4th Ave, Tucson, AZ 85705-8446 | 2007-07-20 |
| 1497058150 | Codac Behavioral Health Services of Pima County, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2226 N Avenida El Capitan, Tucson, AZ 85705-5741 | 2010-12-17 |
| 1730208851 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 700 N 7th Ave, Tucson, AZ 85705-8307 | 2007-03-28 |
| 1356374953 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 1671 W Grant Rd, Tucson, AZ 85745-1433 | 2006-07-08 |
| Street Address |
4901 E 5TH ST |
| City | TUCSON |
| State | AZ |
| Zip Code | 85711-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417992181 | Zacharias Knickerbocker | Social Worker | 4901 E 5th St, Tucson, AZ 85711-2203 | 2006-06-18 |
| 1851685952 | Bill E Owenby | Counselor | 4901 E 5th St, Tucson, AZ 85711-2203 | 2011-06-06 |
| 1477863744 | Yanina V, Shames | Nurse Practitioner | 4901 E 5th St, Codac, Tucson, AZ 85711-2203 | 2010-10-20 |
| 1124357108 | Deborah Lynn Christensen | Registered Nurse | 4901 E 5th St, Tucson, AZ 85711-2203 | 2009-12-21 |
| 1124206610 | Alanna B Boyd | Counselor | 4901 E 5th St, Tucson, AZ 85711-2203 | 2008-02-06 |
| 1013115609 | Carol Lynn Araiza | Registered Nurse | 4901 E 5th St, Tucson, AZ 85711-2203 | 2007-07-05 |
| 1376631259 | Jack E. Hollis | Counselor | 4901 E 5th St, Tucson, AZ 85711-2203 | 2006-10-10 |
| 1629093141 | Bonnie Hoff | Nurse Practitioner | 4901 E 5th St, Tucson, AZ 85711-2203 | 2006-07-13 |
| 1972533560 | Melissa Lynn Johnson | Counselor | 4901 E 5th St, Tucson, AZ 85711-2203 | 2006-07-03 |
| 1376572453 | Cheryl Murdock | Registered Nurse | 4901 E 5th St, Tucson, AZ 85711-2203 | 2006-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356959951 | Ridgeline Practice | Counselor | 4625 N Broadway, Suite 105, Tucson, AZ 85711 | 2020-07-20 |
| 1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
| 1992343362 | Laurie Anne Mcmahon | Family Medicine | 899 N. Wilmot, Building B, Tucson, AZ 85711 | 2019-12-17 |
| 1063060093 | Sharese Ann Bailey | Counselor | 300 S Craycroft Rd, Tucson, AZ 85711 | 2019-09-03 |
| 1467940015 | Jin Zhang | Ophthalmology | 655 N Alvernon Way Ste 204, Tucson, AZ 85711 | 2018-04-30 |
| 1447779525 | Catherine Butler Hobart | Pharmacist | 535 North Wilmont Road, Suite 101, Tucson, AZ 85711 | 2017-09-11 |
| 1689196420 | Cope Community Services, Inc. | Case Management | 924 N Alvernon Way, Tucson, AZ 85711 | 2017-07-13 |
| 1124561477 | Regina Maendler | Behavioral Analyst | 630 N. Craycroft Rd, Tucson, AZ 85711 | 2016-11-18 |
| 1881140184 | Elleda Linsmeyer | Speech-Language Pathologist | St. Joesph's Hosptial, 350 N. Wilmont Rd., Tucson, AZ 85711 | 2016-08-28 |
| 1962856260 | Csl-tucson, LLC | Assisted Living Facility | 1020 N. Woodland Avenue, Tucson, AZ 85711 | 2016-04-22 |
| Find all providers in zip 85711 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093240020 | Cottonwood Tucson Outpatient Services | Clinic/Center | 4110 W Sweetwater Dr Bldg 16, Tucson, AZ 85745-9348 | 2017-04-27 |
| 1760916407 | Grace Home Assisted Living 1 | Clinic/Center | 2301 S Quail Hollow Dr, Tucson, AZ 85710-7986 | 2017-04-19 |
| 1730534405 | New Horizons Behavioral Health Services Inc | Clinic/Center | 5849 E 5th St, Tucson, AZ 85711-2403 | 2016-04-29 |
| 1205293487 | Neuropco LLC | Clinic/Center | 4061 E Via Del Vireo, Tucson, AZ 85718-3311 | 2016-01-20 |
| 1265806186 | Banner -- University Medicine Crisis Response Center LLC | Clinic/Center | 2802 E District St Fl 1, Tucson, AZ 85714-2081 | 2015-11-16 |
| 1457755183 | Barrabee Therapy LLC | Clinic/Center | 2299 W. Camino San Acacio, Tucson, AZ 85741-3696 | 2014-10-09 |
| 1487984720 | Desert Milagros, LLC | Clinic/Center | 3438 N. Country Club Road, Tucson, AZ 85716-1257 | 2010-01-09 |
| 1588814685 | Valerie M. Kading, Np, P.l.l.c | Clinic/Center | 6969 E Sunrise Dr, Suite 202, Tucson, AZ 85750-0720 | 2008-09-24 |
| 1770742959 | University Physicians Healthcare | Clinic/Center | 2800 E. Ajo Way, Tucson, AZ 85713-3204 | 2008-06-03 |
| 1033319751 | Codac Behavioral Health Services of Pima County, Inc. | Clinic/Center | 721 N 4th Ave, Tucson, AZ 85705-8446 | 2007-07-20 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.