People of Color Network

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

BH-2585 Issued in AZ

Legal business name

PEOPLE OF COLOR NETWORK

Practice address

77 E.Thomas Road
Suite 230
Phoenix, AZ 85012-3100

Phone

(602) 253-3084

Fax

(602) 253-3732

NPI assigned

Nov 8, 2005

Organization subpart

No

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

Authorized official

Name

Manuel Tomas Leon

Title

Chief Executive Officer

Phone

(602) 253-3084

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vernon Barksdale, MD,MPH

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1871547380
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1194706986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 EAST THOMAS ROAD",
            "address_2": "SUITE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123100",
            "telephone_number": "602-253-3084",
            "fax_number": "602-253-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E.THOMAS ROAD",
            "address_2": "SUITE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123100",
            "telephone_number": "602-253-3084",
            "fax_number": "602-253-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLE OF COLOR NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "TOMAS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-253-3084"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AZ",
            "license": "BH-2585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER NUMBER",
            "identifier": "703547",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BEHAVIORAL HEALTH",
            "identifier": "BH2828",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Wells Penrod, PA-C
• Tim Penrod, LMFT
• Stephanie Marie Penton, MD
• Timothy Penton
• People of Color Network
• People of Color Network
• People of Color Network
• People of Color Network
• People of Color Network
• Peoplefirst Homecare & Hospice of Utah, LLC

• Adolescent and Children Mental Health Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adolescent and Children Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.