Organization
EASTER SEALS BLAKE FOUNDATION
Active
Organization
EASTER SEALS BLAKE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA S ARENDT (CFO)
(520) 327-1529
Entity
Organization
Contact information
Practice address
709 N ALLRED LN STE 106, THATCHER, AZ 85552-5561
(520) 327-1529
Mailing address
7750 E. BROADWAY BLVD, SUITE A-200, TUCSON, AZ 85710
(520) 327-1529
(520) 327-1836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
OTC8598
AZ
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC12998
ADHS LICENSE
AZ
Enumeration date
01/10/2018
Last updated
07/22/2026
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