NPIMap

Organization Active NPI

Successful Journeys, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Goodyear, AZ
National Provider Identifier
1013141407
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH3254 Issued in AZ
Legal business name
SUCCESSFUL JOURNEYS, LLC
Practice address
4434 N 153Rd LN
Goodyear, AZ 85395-6302
Phone
(623) 535-1239
Fax
(623) 535-1406
NPI assigned
May 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Authorized official

Name
Dr. David Agyapong
Title
Ceo
Phone
(615) 310-6325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH3254 AZ Primary

Addresses

Primary practice location

4434 N 153Rd LN
Goodyear, AZ 85395-6302

Mailing address

12224 N 45TH LN
Glendale, AZ 85304-2312
Phone (623) 293-8022

Other identifiers 1

IdentifierTypeStateIssuer
430383MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Successful Journeys LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1013141407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12224 N 45TH LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042312",
            "telephone_number": "623-293-8022",
            "fax_number": "602-693-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 N 153RD LN",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853956302",
            "telephone_number": "623-535-1239",
            "fax_number": "623-535-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSFUL JOURNEYS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "AGYAPONG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-310-6325",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH3254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430383",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.