Organization Active NPI

Mestiny Behavioral LLC

  • Adult Mental Health Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1104514694
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MESTINY BEHAVIORAL LLC
Practice address
11417 N 33Rd Ave
Phoenix, AZ 85029-3236
Phone
(623) 552-0135
NPI assigned
Apr 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Samuel Oghenejabor
Title
Ceo
Phone
(623) 552-0135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

11417 N 33Rd Ave
Phoenix, AZ 85029-3236

Mailing address

11417 N 33Rd Ave
Phoenix, AZ 85029-3236
Phone (623) 552-0135

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1104514694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11417 N 33RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293236",
            "telephone_number": "623-552-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11417 N 33RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293236",
            "telephone_number": "623-552-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESTINY BEHAVIORAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "OGHENEJABOR",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-552-0135"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.