Organization Active NPI

The Meadows Ranch Outpatient Center LLC

  • Adult Mental Health Clinic/Center
  • Wickenburg, AZ
National Provider Identifier
1508506551
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
THE MEADOWS RANCH OUTPATIENT CENTER LLC
Practice address
1901 Gold Nugget Lane
Mountain View Building
Wickenburg, AZ 85390-4358
Phone
(602) 256-3020
NPI assigned
Mar 29, 2022
Last updated
Feb 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Ms. Tracy Livingston
Title
VP of Revenue Cycle Management
Phone
(602) 256-3020

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

1901 Gold Nugget Lane
Mountain View Building
Wickenburg, AZ 85390-4358

Mailing address

19820 N 7TH St Ste 205
Phoenix, AZ 85024-1694
Phone (928) 684-4039

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1028053Meadows Ranch, the1901 Gold Nugget Lane, Wickenburg, AZ 85390Certificate of waiverJul 19, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1508506551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19820 N 7TH ST STE 205",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241694",
            "telephone_number": "928-684-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 GOLD NUGGET LANE",
            "address_2": "MOUNTAIN VIEW BUILDING",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853904358",
            "telephone_number": "602-256-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEADOWS RANCH OUTPATIENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "LIVINGSTON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "602-256-3020",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickenburg, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.