Civara Behavioral Health LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

CIVARA BEHAVIORAL HEALTH LLC

Practice address

4010 W Cactus Rd
Phoenix, AZ 85029-2905

Phone

(480) 329-9585

Fax

(602) 237-5211

NPI assigned

Oct 1, 2020

Organization subpart

No

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

Authorized official

Name

Vittelian Forbes, PHARMDNPI 1124463138

Title

Owner

Phone

(480) 329-9585

Specialties & licenses 2

Addresses

Practitioners 1

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

• Vittelian Forbes, RPH

  • Pharmacist
  • Phoenix, AZ
  • NPI 1124463138
  NPD (past) Authorized official

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1013524230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 E MORELAND ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573318",
            "telephone_number": "480-329-9585",
            "fax_number": "602-237-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W CACTUS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292905",
            "telephone_number": "480-329-9585",
            "fax_number": "602-237-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVARA BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "FORBES",
        "authorized_official_first_name": "VITTELIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-329-9585",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City Help, Inc.
• City of Hope Medical Group of Arizona LLC
• City of Phoenix Arizona
• Corinne C Ciuris, R.D.
• Brian Ciurlino, MD
• Courtney Civelli, MD
• David Civic, MD
• Emily Katherine Claassen, MED, LBA, BCBA
• Alexander Clabourne, RDN
• Alejandra Clamor

• Psychiatric Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatric Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.