TJ Gardner Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

TJ GARDNER CENTER LLC

Practice address

1722 N Banning Ste 101B
Mesa, AZ 85205-3350

Phone

(480) 466-4837

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Hayden Won Min Phillip Duff

Title

Owner

Phone

(480) 466-4837

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1285340547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 N BANNING STE 101B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053350",
            "telephone_number": "480-466-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 N BANNING STE 101B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852053350",
            "telephone_number": "480-466-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TJ GARDNER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "DUFF",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_middle_name": "WON MIN PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-466-4837"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Tisoncik, DPT
• Jessica Titus
• Pragya Tiwari-Sharma, M.D.
• Pavan Kumar Tiyyagura, MD
• TJ Fulton Investment Group LLC
• TJ&S Corporation
• Scott L Tjan, P.T.
• Valdy Tjong, PHARMD
• TLC Services, LLC
• TLC/Transitional Living Communities

• Adult Mental Health Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.