Active NPI
Stargate Behavioral Health Services LLC
- Community/Behavioral Health Agency
- Glendale, AZ
National Provider Identifier
1104413863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- STARGATE BEHAVIORAL HEALTH SERVICES LLC
- Practice address
- 7346 N 72ND Ave
Glendale, AZ 85303-1602 - Phone
- (216) 630-9350
- Fax
- (602) 581-3000
- NPI assigned
- Dec 29, 2020
- Organization subpart
- Yes
- Parent organization
- -
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sekou A Donzo, MALIKEE SONIE
- Title
- Co Owner/Administrator
- Phone
- (216) 630-9350
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
7346 N 72ND Ave
Glendale, AZ 85303-1602
Mailing address
7346 N 72ND Ave
Glendale, AZ 85303-1602
Phone (216) 630-9350
National Provider Directory
National Provider Directory- Tax ID family
- Stargate Behavioral Health Services LLC
- Part of
- Stargate Behavioral Health Services LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Phoenix, AZ
- NPI 1063974533
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609200000000",
"number": "1104413863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7346 N 72ND AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853031602",
"telephone_number": "216-630-9350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7346 N 72ND AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853031602",
"telephone_number": "216-630-9350",
"fax_number": "602-581-3000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STARGATE BEHAVIORAL HEALTH SERVICES LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "-",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A",
"authorized_official_last_name": "DONZO",
"authorized_official_first_name": "SEKOU",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CO OWNER/ADMINISTRATOR",
"authorized_official_telephone_number": "216-630-9350",
"authorized_official_credential": "MALIKEE SONIE"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.