NPIMap

Organization Active NPI

Supreme Positive Innovation Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mesa, AZ
National Provider Identifier
1003401902
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SUPREME POSITIVE INNOVATION SERVICES LLC
Practice address
1833 W Main St Ste 139-140
Mesa, AZ 85201-6922
Phone
(602) 757-6786
NPI assigned
Mar 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Katelyn Tamas
Title
Owner
Phone
(602) 757-6786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1833 W Main St Ste 139-140
Mesa, AZ 85201-6922

Mailing address

1833 W Main St Ste 139-140
Mesa, AZ 85201-6922

National Provider Directory

National Provider Directory
Tax ID family
Supreme Positive Innovation Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1003401902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 W MAIN ST STE 139-140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 W MAIN ST STE 139-140",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016922",
            "telephone_number": "602-757-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME POSITIVE INNOVATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "TAMAS",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-757-6786"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; 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.