Denali Youth Homes of Arizona LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

DENALI YOUTH HOMES OF ARIZONA LLC

Practice address

5747 W Warner St
Phoenix, AZ 85043-6432

Phone

(907) 301-0333

NPI assigned

Nov 5, 2024

Organization subpart

No

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

Authorized official

Name

Johnny Tyson

Title

Ceo

Phone

(907) 301-0333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1215750401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5747 W WARNER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850436432",
            "telephone_number": "907-301-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5747 W WARNER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850436432",
            "telephone_number": "907-301-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENALI YOUTH HOMES OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-301-0333"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marja Dempsey, AGACNP-BC, FNP
• Daniel George Demumbrum, RPH
• Ismita Demuro, APRN
• Shanna Michelle Demus
• Stacy Dena
• Willie Ruth Denard, LCSW
• Christine Elaine Denardo, SLP-A
• Melissa A Dencklau, D.C.
• Deng Entererprises, LLC DBG J & T Transportation
• Pedro Denga

• Children's Substance Abuse Rehabilitation Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Children's Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.