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Organization

EASTER SEALS BLAKE FOUNDATION

Active
Other names
Blake Foundation
Organization subpart
No

Provider details

NPI number
Authorized official
MARISSA S ARENDT (CFO)
(520) 327-1529
Entity
Organization

Contact information

Practice address
900 E FLORENCE BLVD STE A, CASA GRANDE, AZ 85122-4673
(520) 723-4429
Mailing address
7750 E BROADWAY BLVD STE A200, TUCSON, AZ 85710-3903
(520) 327-1529
(520) 327-1836

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
BH-4277
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTC20104
ADHS
AZ
Enumeration date
07/19/2013
Last updated
10/07/2025
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