Next Level Vitality LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NEXT LEVEL VITALITY LLC

Practice address

26 W Brahman Blvd
San Tan Valley, AZ 85143-4852

Phone

(619) 366-1546

NPI assigned

Aug 15, 2019

Last updated

Sep 22, 2022By 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

Tia RossNPI 1619461571

Title

Owner

Phone

(619) 366-1546

Specialties & licenses 2

Addresses

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.

• Tia Ross

  • Assistant Behavior Analyst
  • Las Vegas, NV
  • NPI 1619461571
  Authorized official Same address or phone

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1407402316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 W BRAHMAN BLVD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851434852",
            "telephone_number": "619-366-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W BRAHMAN BLVD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851434852",
            "telephone_number": "619-366-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXT LEVEL VITALITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-15",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "TIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-366-1546"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

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