PTL Behavioral Health, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PTL BEHAVIORAL HEALTH, LLC

Practice address

10839 E Sonrisa Ave
Mesa, AZ 85212-5126

Phone

(480) 485-6075

Fax

(480) 485-6865

NPI assigned

May 31, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Stephen Kissi Lauder Sr.

Title

Administrator

Phone

(480) 516-9075

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philomina Anderson Lauder

  • Social Worker
  • Mesa, AZ
  • NPI 1427472067
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003344367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10839 E SONRISA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852125126",
            "telephone_number": "480-485-6075",
            "fax_number": "480-485-6865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10839 E SONRISA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852125126",
            "telephone_number": "480-485-6075",
            "fax_number": "480-485-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PTL BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LAUDER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "KISSI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-516-9075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trent Pruitt
• Derek P Pruni, DC
• Charles H Pshaenich, MD
• Psychology Practice of Judith Rand PHD PLC
• Psychotherapy Associates of Arizona, Inc.
• Pueblo Pediatrics LTD
• Heidi Puga
• Kevin Pugh, OD
• Sharon Pugliese
• Justin L Pugmire, PT, DPT

• Mental Illness Community Based Residential Treatment Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.