Organization Active NPI

Step Up Arizona

  • Community/Behavioral Health Agency
  • Avondale, AZ
National Provider Identifier
1477916203
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CSLG7614 Issued in AZ
Legal business name
STEP UP ARIZONA
Practice address
12725 W Indian School Rd # E109
Avondale, AZ 85392-9520
Phone
(602) 361-9724
NPI assigned
Mar 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Kim Molina, MANPI 1326408006
Title
Vice President
Phone
(623) 466-7233

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
Community/Behavioral Health Agency 251S00000X CSLG7614 AZ Primary

Addresses

Primary practice location

12725 W Indian School Rd # E109
Avondale, AZ 85392-9520

Mailing address

12725 W Indian School Rd # E109
Avondale, AZ 85392-9520
Phone (602) 361-9724

National Provider Directory

National Provider Directory

Locations

12725 W Indian School Rd
#E109
Avondale, AZ 85392
Phone (602) 361-9724

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1477916203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 W INDIAN SCHOOL RD # E109",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929520",
            "telephone_number": "602-361-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 W INDIAN SCHOOL RD # E109",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929520",
            "telephone_number": "602-361-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEP UP ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-30",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "MOLINA",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "623-466-7233",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "CSLG7614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.