NPIMap

Organization Active NPI

Summit Behavioral Health of Arizona

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Prescott Valley, AZ
National Provider Identifier
1023471646
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SUMMIT BEHAVIORAL HEALTH OF ARIZONA
Practice address
8705 E Eastridge Rd
Prescott Valley, AZ 86314-8563
Phone
(928) 710-7021
Fax
(928) 708-9620
NPI assigned
Mar 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Authorized official

Name
Benjamin T Isenberg
Title
Ceo
Phone
(928) 710-7021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

8705 E Eastridge Rd
Prescott Valley, AZ 86314-8563

Mailing address

637 W Hillside Ave
Prescott, AZ 86301-1909
Phone (928) 710-7021

National Provider Directory

National Provider Directory
Tax ID family
Summit Behavioral Health of Az LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1023471646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 W HILLSIDE AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011909",
            "telephone_number": "928-710-7021",
            "fax_number": "928-708-9620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 E EASTRIDGE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148563",
            "telephone_number": "928-710-7021",
            "fax_number": "928-708-9620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT BEHAVIORAL HEALTH OF ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "ISENBERG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-710-7021"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.