Copper Cactus Behavioral Health LC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

COPPER CACTUS BEHAVIORAL HEALTH LC

Practice address

4715 W Maldonado Rd
Laveen, AZ 85339-8214

Phone

(480) 930-3646

NPI assigned

Apr 27, 2021

Organization subpart

No

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

Authorized official

Name

Kyona Jessell Relf

Title

Owner

Phone

(480) 930-3646

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1184206369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8437 S 50TH DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853392165",
            "telephone_number": "312-962-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 W MALDONADO RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853398214",
            "telephone_number": "480-930-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER CACTUS BEHAVIORAL HEALTH LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "RELF",
        "authorized_official_first_name": "KYONA",
        "authorized_official_middle_name": "JESSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-930-3646"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Comprehensive Group Home LLC
• Ann Donell Connelly, M.ED.
• Towanda Nicole Connelly, LCSW
• Cook Family Medicine, PLLC
• Sharon Denise Cooper
• Copper Health Consults PLLC
• Copper Valley Integrated Health LLC
• Terry Cortez
• Cotton Field Assisting Living
• Covenant Behavioral Health Residential Facility.

• Substance Abuse Rehabilitation Facility in Laveen, AZ
• Providers in Laveen, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.