Justin Mabany

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

License

BH6750 Issued in AZ

Practice address

9525 W Minnezona Ave
Phoenix, AZ 85037-1349

Phone

(623) 872-5454

NPI assigned

Aug 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sun State Behavioral, LLC

  • Assisted Living Facility (Behavioral Disturbances)
  • Phoenix, AZ
  • NPI 1619649845

  Assisted Living, Behavioral Disturbances

  NPD Authorized official

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1033886338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 W MINNEZONA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371349",
            "telephone_number": "602-384-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 W MINNEZONA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371349",
            "telephone_number": "623-872-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABANY",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "AZ",
            "license": "BH6750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ly Thien Ma, M.D.
• Maa Wellness Center
• Daniel Tyler Maas, DO
• Shannon Maaske, OTR/L
• Anas Maatough, MD
• Matthew Benjamin Mabbitt, RN
• Chad Steven Mabee, LAC
• Joseph A Mabilia, D.O.
• Candace Olivia Mabry, RN
• Chatara Mabry, LMSW

• Assisted Living Facility (Behavioral Disturbances) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Assisted Living Facility (Behavioral Disturbances) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.