Organization
EASTER SEALS BLAKE FOUNDATION
Active
Organization
EASTER SEALS BLAKE FOUNDATION
Active
Other names
Agape House
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA S ARENDT (CFO)
(520) 327-1529
Entity
Organization
Contact information
Practice address
4454 E 3RD ST, TUCSON, AZ 85711-1189
(520) 881-3090
Mailing address
7750 E BROADWAY BLVD, STE. A200, TUCSON, AZ 85710-3901
(520) 327-1529
(520) 327-1836
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-4429
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
881725
AHCCCS PROVIDER
AZ
01
—
BH4429
AZ BEHAVIORAL HEALTH RESIDENTIAL FACILITY LICENSE
AZ
Enumeration date
12/02/2013
Last updated
08/03/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up