Adventure Discovery Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH-650 Issued in AZ

Legal business name

ADVENTURE DISCOVERY INC

Practice address

403 W Birch Ave
Flagstaff, AZ 86001-4467

Phone

(928) 774-1926

Fax

(928) 779-4273

NPI assigned

Oct 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Jensen, MA LPC

Title

Executive Director

Phone

(928) 774-1926

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336224336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W BIRCH AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014467",
            "telephone_number": "928-774-1926",
            "fax_number": "928-779-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W BIRCH AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014467",
            "telephone_number": "928-774-1926",
            "fax_number": "928-779-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTURE DISCOVERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "928-774-1926",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN#",
            "identifier": "134536",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.