NPIMap

Organization Active NPI

Paradise Valley Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1417468398
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH5158 Issued in AR
Legal business name
PARADISE VALLEY BEHAVIORAL HEALTH
Practice address
13401 N 30TH St
Phoenix, AZ 85032-6028
Phone
(602) 400-2288
Fax
(602) 996-1577
NPI assigned
Oct 18, 2017
Organization subpart
Yes
Parent organization
PARADISE VALLEY BEHAVIORAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Authorized official

Name
David Cardoso
Title
Program Director / Owner
Phone
(602) 400-2288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH5158 AR Primary

Addresses

Primary practice location

13401 N 30TH St
Phoenix, AZ 85032-6028

Mailing address

3015 E Gelding Dr
Phoenix, AZ 85032-5032
Phone (602) 400-2288

Other identifiers 1

IdentifierTypeStateIssuer
BH5158OtherAZDEPARTMENT OF BEHAVIORAL HEALTH

National Provider Directory

National Provider Directory
Tax ID family
Paradise Valley Behavioral Heath Inna3 organizations share this tax ID, including this one
Part of
Paradise Valley Behavioral Heath Inna

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508284800000",
    "number": "1417468398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E GELDING DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325032",
            "telephone_number": "602-400-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13401 N 30TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850326028",
            "telephone_number": "602-400-2288",
            "fax_number": "602-996-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE VALLEY BEHAVIORAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARADISE VALLEY BEHAVIORAL HEALTH",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-10-18",
        "status": "A",
        "authorized_official_last_name": "CARDOSO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR / OWNER",
        "authorized_official_telephone_number": "602-400-2288"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AR",
            "license": "BH5158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF BEHAVIORAL HEALTH",
            "identifier": "BH5158",
            "state": "AZ"
        }
    ],
    "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 Oct 18, 2017; 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.