NPIMap

Organization Active NPI

Springbrook Inc

  • Community/Behavioral Health Agency
  • Scottsdale, AZ
National Provider Identifier
1023190618
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-2868 Issued in AZ
Legal business name
SPRINGBROOK INC
Practice address
4835 E Cactus Rd
Suite 460
Scottsdale, AZ 85254-4191
Phone
(602) 424-1838
Fax
(602) 424-7879
NPI assigned
Oct 20, 2006
Last updated
Dec 31, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Mr. George W Green Jr., M.ED.
Title
Clinical Director
Phone
(602) 424-1838

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-2868 AZ Primary
Mental Illness Community Based Residential Treatment Facility 320800000X BH-2372 AZ
Mental Illness Community Based Residential Treatment Facility 320800000X BH-3021 AZ

Addresses

Primary practice location

4835 E Cactus Rd
Suite 460
Scottsdale, AZ 85254-4191

Mailing address

4835 E Cactus Rd
Suite 460
Scottsdale, AZ 85254-4191
Phone (602) 424-1838

Other identifiers 1

IdentifierTypeStateIssuer
886658MedicaidAZ

Other names 1

  • Springbrook Habilitation Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Springbrook Habilitation Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4835 E Cactus Rd
Ste 460
Scottsdale, AZ 85254
Phone (602) 424-1838

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1023190618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 E CACTUS RD",
            "address_2": "SUITE 460",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544191",
            "telephone_number": "602-424-1838",
            "fax_number": "602-424-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 E CACTUS RD",
            "address_2": "SUITE 460",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852544191",
            "telephone_number": "602-424-1838",
            "fax_number": "602-424-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGBROOK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "602-424-1838",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-2868",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-2372",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886658",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springbrook Habilitation Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.