CODAC HEALTH, RECOVERY & WELLNESS, INC. (NPI# 1487687182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487687182 |
| Entity Type | Organization |
| Organization Name | CODAC HEALTH, RECOVERY & WELLNESS, INC. |
| Other Organization Name | CODAC FIRST/METHADONE |
| Practice Address |
3100 N 1st Ave Tucson AZ 85719-2513 |
| Mailing Address |
1650 E Fort Lowell Rd Ste 202 Tucson AZ 85719-2378 |
| Practice Telephone | 5202021960 |
| Practice Fax Number | 5206225358 |
| Mailing Telephone | 5203274505 |
| Mailing Fax Number | 5202021889 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2015-10-14 |
| Authorized Official Name | MR. DENNIS REGNIER (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 |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA LICENSE | OTC5996 | 01 |
| AZ | 354217 | 05 |
| Other Name | Type Code |
|---|---|
| CODAC First/Methadone | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699226068 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2482 N Palo Verde Ave, Tucson, AZ 85716-2548 | 2016-10-20 |
| 1255881355 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4801 E Helen St, Tucson, AZ 85712-4717 | 2016-10-12 |
| 1518358530 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1600 N Country Club Rd, Tucson, AZ 85716-3119 | 2015-02-12 |
| 1750797692 | Codac Health, Recovery & Wellness, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4758 E Andrew St, Tucson, AZ 85711-6427 | 2014-07-10 |
| 1952685414 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1080 S 10th Ave, Tucson, AZ 85701-2907 | 2011-10-03 |
| 1467475434 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 502 N Silverbell Rd, Tucson, AZ 85745-2626 | 2006-07-25 |
| 1730570102 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 101 W Irvington Rd, Office 3 A, Tucson, AZ 85714-3050 | 2015-02-06 |
| 1376931493 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2014-12-23 |
| 1801207642 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 3130 E Broadway Blvd, Tucson, AZ 85716-5863 | 2014-05-14 |
| 1235569328 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 2001 W Orange Grove Rd, Ste 416, Tucson, AZ 85704-1139 | 2013-11-26 |
| Street Address |
3100 N 1ST AVE |
| City | TUCSON |
| State | AZ |
| Zip Code | 85719-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487680146 | Dawn Florence Crawford-rogers | Social Worker | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2006-06-24 |
| 1245644558 | Chang Wook Lee | Counselor | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2014-06-13 |
| 1730475195 | Myrna Garcia | Counselor | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2011-06-23 |
| 1245523976 | Kimberly Schulz | Counselor | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2011-05-27 |
| 1619163656 | Kenneth Richard Jones | Nurse's Aide | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2007-09-24 |
| 1487840591 | Nina Perrette | Licensed Practical Nurse | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2007-09-21 |
| 1780605568 | Lina A. Rosin | Nurse Practitioner | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2006-07-21 |
| 1447275458 | Ilaann White | Licensed Practical Nurse | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2006-07-12 |
| 1578598389 | Diana Williams | Licensed Practical Nurse | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2006-07-11 |
| 1467487272 | Eliza Juan | Licensed Practical Nurse | 3100 N 1st Ave, Tucson, AZ 85719-2513 | 2006-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649813635 | Ishani Ravindra Deo | Psychologist | 1051 E Mabel St, Tucson, AZ 85719 | 2019-10-22 |
| 1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
| 1831652189 | Derek Allan Hatfield | Emergency Medicine | 1625 N Campbell Ave., Tucson, AZ 85719 | 2019-04-12 |
| 1053874305 | Travis Patrick Martin | Emergency Medicine | 1625 N. Campbell Ave, Tucson, AZ 85719 | 2019-04-12 |
| 1245793504 | Martin Cisneroz | Emergency Medicine | 1625 North Campbell Avenue, Tucson, AZ 85719 | 2019-04-12 |
| 1174086722 | Sarah Joy Ring | Emergency Medicine | 1625 N. Campbell Ave., Tucson, AZ 85719 | 2019-04-10 |
| 1790245520 | Akash M Doshi | Student in an Organized Health Care Education/Training Program | 3838 N Campbell Avenue, Bldg 2, Tuscon, AZ 85719 | 2019-03-20 |
| 1942773668 | Jeffery Roy Small | Massage Therapist | 3607 N Vine, Tucson, AZ 85719 | 2019-01-04 |
| 1114434180 | Elizabeth Irene Welch | Behavioral Analyst | 1430 E Fort Lowell Rd Ste 100, Tucson, AZ 85719 | 2017-12-29 |
| 1477076255 | Medavail Pharmacy Inc. | Pharmacy | 1430 E Fort Lowell Rd Ste 120, Tucson, AZ 85719 | 2017-07-24 |
| Find all providers in zip 85719 | ||||
| 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.