NPIMap

Organization Active NPI

Audacious Living LLC

  • Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1326652652
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
AUDACIOUS LIVING LLC
Practice address
1922 W Las Palmaritas Dr Apt J110
Phoenix, AZ 85021-5041
Phone
(702) 683-5187
NPI assigned
Sep 3, 2020
Last updated
Sep 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Cassandra HildrethNPI 1245533272
Title
Owner
Phone
(702) 683-5187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1922 W Las Palmaritas Dr Apt J110
Phoenix, AZ 85021-5041

Mailing address

1922 W Las Palmaritas Dr Apt J110
Phoenix, AZ 85021-5041

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1326652652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 W LAS PALMARITAS DR APT J110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 W LAS PALMARITAS DR APT J110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215041",
            "telephone_number": "702-683-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDACIOUS LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "HILDRETH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-683-5187"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 20, 2022; 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.