CODAC AT ALVERNON – NPI #1174862007
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CODAC AT ALVERNON is an AHC clinic located in TUCSON, AZ. NPPES has assigned the NPI number 1174862007 to CODAC AT ALVERNON on February 13, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CODAC AT ALVERNON” is a dba name, the actual legal business name for this organization is CODAC HEALTH, RECOVERY & WELLNESS, INC.. The primary taxonomy selected by this provider is 261QM0850X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adult Mental Health

The NPI profile was previously updated about 11 years ago on Sep 25, 2015. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CODAC AT ALVERNON below.

NPI Profile for
CODAC HEALTH, RECOVERY & WELLNESS, INC.

NPI Number
1174862007
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CODAC HEALTH, RECOVERY & WELLNESS, INC.
Doing Business As (dba): CODAC AT ALVERNON
Primary location
630 N ALVERNON WAY
STE 161
TUCSON, AZ 85711-1843
Phone: (520) 318-9222 Fax: (520) 318-3443
Mailing address
1650 E FORT LOWELL RD
STE 202
TUCSON, AZ 85719-2374
Phone: (520) 327-4505 Fax: (520) 202-1889
Organization Subpart
No
Authorized Official
DENNIS REGNIER
CEO
Phone: (520) 327-4505
Updated
Identifiers

Identifiers for CODAC AT ALVERNON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDAZ805051
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0850X
- Clinic/Center / Adult Mental Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.