Organization
EASTER SEALS BLAKE FOUNDATION
Active
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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