NPIMap

Organization Active NPI

Angel Heart Behavioral Health LLC

Doing business as Angel Heart Behavioral Health

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1255820098
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ANGEL HEART BEHAVIORAL HEALTH LLC
Doing business as
Angel Heart Behavioral Health
Practice address
11114 W College Dr
Phoenix, AZ 85037-1269
Phone
(207) 409-6515
Fax
(623) 777-0427
NPI assigned
May 8, 2018
Last updated
May 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Authorized official

Name
Aimee N Nyirakanyana
Title
Administrator
Phone
(207) 409-6515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X AZ Primary

Addresses

Primary practice location

11114 W College Dr
Phoenix, AZ 85037-1269

Mailing address

11114 W College Dr
Phoenix, AZ 85037-1269
Phone (207) 409-6515

Other identifiers 1

IdentifierTypeStateIssuer
00000MedicaidAZ

Other names 1

  • ANGEL HEART BEHAVIORAL HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Angel Heart Behavavioral Health4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1255820098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11114 W COLLEGE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371269",
            "telephone_number": "207-409-6515",
            "fax_number": "623-777-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11114 W COLLEGE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371269",
            "telephone_number": "207-409-6515",
            "fax_number": "623-777-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL HEART BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "NYIRAKANYANA",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-409-6515"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANGEL HEART BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.