Organization Active NPI

Beacon Wellness Center LLC

Doing business as Beacon Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Queen Creek, AZ
National Provider Identifier
1386267797
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BEACON WELLNESS CENTER LLC
Doing business as
Beacon Wellness Center
Practice address
21258 E Rittenhouse Rd Ste 104
Queen Creek, AZ 85142-9340
Phone
(480) 306-4127
NPI assigned
May 20, 2020
Last updated
May 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Cameron Dupree Trotter
Title
Ceo
Phone
(480) 375-5937

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

21258 E Rittenhouse Rd Ste 104
Queen Creek, AZ 85142-9340

Mailing address

21258 E Rittenhouse Rd Ste 104
Queen Creek, AZ 85142-9340
Phone (480) 306-4127

Other names 1

  • BEACON WELLNESS CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL bbhservices.org Direct

National Provider Directory

National Provider Directory

Locations

21258 E Rittenhouse Rd
Ste 104
Queen Creek, AZ 85142
Phone (480) 306-4127

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1386267797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21258 E RITTENHOUSE RD STE 104",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429340",
            "telephone_number": "480-306-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21258 E RITTENHOUSE RD STE 104",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851429340",
            "telephone_number": "480-306-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_middle_name": "DUPREE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-375-5937"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "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": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bbhservices.org",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure database",
            "address_1": "21258 E Rittenhouse Rd Ste 104",
            "city": "Queen Creek",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851429340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "BEACON WELLNESS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.