Organization
EASTER SEALS BLAKE FOUNDATION
Active
Organization
EASTER SEALS BLAKE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARISSA S ARENDT (CFO)
(520) 327-1529
Entity
Organization
Contact information
Practice address
7750 E BROADWAY BLVD, SUITE A200, TUCSON, AZ 85710
(520) 327-1529
(520) 327-1836
Mailing address
7750 E BROADWAY BLVD, SUITE A200, TUCSON, AZ 85710
(520) 327-1529
(520) 327-1836
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042622
—
AZ
Enumeration date
10/04/2006
Last updated
09/01/2023
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