NPIMap

Organization Active NPI

A New Leaf

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glendale, AZ
National Provider Identifier
1013349570
Registry record updated Jul 31, 2024
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
A NEW LEAF
Practice address
8581 N 61St Ave BLDG a
Glendale, AZ 85302-5493
Phone
(623) 934-1991
Fax
(623) 878-9335
NPI assigned
Aug 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Gracia Danis
Title
Credentialing Specialist
Phone
(520) 591-5394

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Primary Care Clinic/Center 261QP2300X OTC6465 AZ

Addresses

Primary practice location

8581 N 61St Ave BLDG a
Glendale, AZ 85302-5493

Mailing address

868 E University Dr
Mesa, AZ 85203-8033
Phone (480) 969-4024

Other identifiers 2

IdentifierTypeStateIssuer
OTC6465OtherAZSTATE LICENSE
433108MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
A New Leaf Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

8581 N 61st Ave
Bldg A
Glendale, AZ 85302
Phone (623) 934-1991

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1013349570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038033",
            "telephone_number": "480-969-4024",
            "fax_number": "480-969-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8581 N 61ST AVE BLDG A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853025493",
            "telephone_number": "623-934-1991",
            "fax_number": "623-878-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A NEW LEAF",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "DANIS",
        "authorized_official_first_name": "GRACIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "520-591-5394"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "OTC6465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OTC6465",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433108",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.