NPIMap

Organization Active NPI

A New Leaf, Inc. - Central Campus Services

  • Adolescent and Children Mental Health Clinic/Center
  • Mesa, AZ
National Provider Identifier
1174965370
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
BH4297 Issued in AZ
Legal business name
A NEW LEAF, INC. - CENTRAL CAMPUS SERVICES
Practice address
960 N Stapley Dr
Building 2 - 8 & 10
Mesa, AZ 85203-5604
Phone
(480) 969-4024
Fax
(480) 969-0039
NPI assigned
Jul 29, 2013
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Gracia Danis
Title
Credentialing Specialist
Phone
(520) 591-5394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X BH4297 AZ Primary

Addresses

Primary practice location

960 N Stapley Dr
Building 2 - 8 & 10
Mesa, AZ 85203-5604

Mailing address

868 E University Dr
Mesa, AZ 85203-8033
Phone (480) 969-4024

National Provider Directory

National Provider Directory
Tax ID family
A New Leaf Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

960 N Stapley Dr
Bldg 2
Mesa, AZ 85203
Phone (480) 969-4024

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1174965370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038033",
            "telephone_number": "480-969-4024",
            "fax_number": "480-969-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 N STAPLEY DR",
            "address_2": "BUILDING 2 - 8 & 10",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852035604",
            "telephone_number": "480-969-4024",
            "fax_number": "480-969-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A NEW LEAF, INC. - CENTRAL CAMPUS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "DANIS",
        "authorized_official_first_name": "GRACIA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "520-591-5394"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AZ",
            "license": "BH4297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.