Konkrete Rose Youth and Family Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KONKRETE ROSE YOUTH AND FAMILY SERVICES LLC

Practice address

3707 E Southern Ave Ste 2054
Mesa, AZ 85206-6217

Phone

(602) 552-2381

NPI assigned

Mar 12, 2024

Organization subpart

No

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

Authorized official

Name

Lauryn May, REGISTERED NURSENPI 1295579357

Title

Ceo

Phone

(602) 552-2381

Specialties & licenses 1

Addresses

Tax ID family

Konkrete Rose Yfs2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Konkrete Rose Youth and Family Services LLC

  • Community/Behavioral Health Agency
  • Gilbert, AZ
  • NPI 1225743099
  NPD tax ID

Locations

Practitioners 4

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

• Lauryn May, RN

  • Registered Nurse
  • Mesa, AZ
  • NPI 1295579357
  NPD Authorized official
• Michael Ryan Brooks, BHT

  • Behavior Technician
  • Gilbert, AZ
  • NPI 1881439610
  NPD
• Darnell K Johnson

  • Behavior Technician
  • Mesa, AZ
  • NPI 1538990668
  NPD
• Maurice Antonio Porter

  • Behavior Technician
  • Mesa, AZ
  • NPI 1710718846
  NPD

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1306604475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 N VAL VISTA DR STE 109-1197",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343706",
            "telephone_number": "602-552-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 E SOUTHERN AVE STE 2054",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066217",
            "telephone_number": "602-552-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONKRETE ROSE YOUTH AND FAMILY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "LAURYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-552-2381",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Aaron Koltun, D.D.S.
• Jacob Kolu, DMD
• Jeff Komar
• Lori Jo Kometer, MA, LIAC
• Kevin Kon, PAC
• Jennifer Koppes
• Molly Koppinger
• Deborah S Korbitz, CNP
• Melissa Korey
• Britany R Kormos, NP-C

• Community/Behavioral Health Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.