NPIMap

Organization Active NPI

DHHS IHS Phoenix Area

Doing business as Desert Visions Youth Wellness Cente

  • Children's Substance Abuse Rehabilitation Facility
  • Sacaton, AZ
National Provider Identifier
1104195353
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
Legal business name
DHHS IHS PHOENIX AREA
Doing business as
Desert Visions Youth Wellness Cente
Practice address
198 S Skill Center Rd
Sacaton, AZ 85247
Phone
(888) 431-4096
NPI assigned
Dec 16, 2011
Last updated
Dec 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Holly Elliott
Title
Chief Executive Officer
Phone
(888) 431-4096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X NU Primary

Addresses

Primary practice location

198 S Skill Center Rd
Sacaton, AZ 85247

Mailing address

PO Box 458
Sacaton, AZ 85147-0008
Phone (888) 431-4096

Other names 1

  • DESERT VISIONS YOUTH WELLNESS CENTE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Desert Visions Youth Wellness Cente2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1104195353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470008",
            "telephone_number": "888-431-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 S SKILL CENTER RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85247",
            "telephone_number": "888-431-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS IHS PHOENIX AREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "888-431-4096"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DESERT VISIONS YOUTH WELLNESS CENTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacaton, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.