Blooming Desert Prickly LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLOOMING DESERT PRICKLY LLC

Practice address

909 W Grove Pkwy Apt 2029
Tempe, AZ 85283-8422

Phone

(775) 287-9463

NPI assigned

Mar 30, 2022

Last updated

Mar 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laryssa IkeharaNPI 1902554736

Title

Owner

Phone

(775) 287-9463

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Laryssa Ikehara

  • Behavior Technician
  • Tempe, AZ
  • NPI 1902554736
  NPD Authorized official

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1114667987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W GROVE PKWY APT 2029",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852838422",
            "telephone_number": "775-287-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W GROVE PKWY APT 2029",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852838422",
            "telephone_number": "775-287-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING DESERT PRICKLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "IKEHARA",
        "authorized_official_first_name": "LARYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-287-9463"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "000000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William B Blocher, DDS
• Emelia Block
• Bloodline Mobile Services LLC
• Joshua Zalman Bloomberg, DO
• Robert Joseph Bloomberg, MD
• Samantha Blovet
• James L Bludworth, PHD
• Sean C Blumhoff, C.C.P.
• Kimberlee Marie Blyden-Taylor, ND
• Magda Bobadilla, RBT

• Mental Health Clinic/Center (Including Community Mental Health Center) in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.