Peaks Youth Behavoral Center LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PEAKS YOUTH BEHAVORAL CENTER LLC

Practice address

642 Dameron Dr Ste B
Prescott, AZ 86301-2411

Phone

(928) 848-6941

NPI assigned

Jun 17, 2026

Organization subpart

No

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

Authorized official

Name

Makenzie Stidham

Title

Member Manager

Phone

(928) 848-6941

Specialties & licenses 1

Addresses

Tax ID family

Peaks Youth Behavioral Health Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Peaks Youth Behavioral Health Center, LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Prescott, AZ
  • NPI 1154262848
  NPD tax ID
• Peaks Youth Behavioral Health Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Prescott, AZ
  • NPI 1255253480
  NPD tax ID

Locations

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

{
    "created_epoch": "1781654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1295660520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 DAMERON DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012411",
            "telephone_number": "928-848-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 DAMERON DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863012411",
            "telephone_number": "928-848-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAKS YOUTH BEHAVORAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "STIDHAM",
        "authorized_official_first_name": "MAKENZIE",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "928-848-6941"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Eugene Paxton, M.D.
• PC Pain Doctors II, PLLC
• Peaks Primary Care, LLC
• Peaks Youth Behavioral Health Center, LLC
• Peaks Youth Behavioral Health Center, LLC
• Michele H Pearson, RN
• Pediatrics in the Pines
• John Pemberton, LCSW
• Abigail Pena
• Heather Ann Penn, PMHNP

• Mental Illness Community Based Residential Treatment Facility in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.