Pinetop Behavioral Health LLC

Primary specialty

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

Legal business name

PINETOP BEHAVIORAL HEALTH LLC

Practice address

674 E White Mountain Blvd # 5
Blvd 5
Pinetop, AZ 85935

Phone

(207) 409-6515

NPI assigned

Jun 23, 2022

Last updated

Jun 23, 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

Aimee Nyirakanyana

Title

Owner

Phone

(207) 409-6515

Specialties & licenses 1

Addresses

Tax ID family

Pinetop Behavioral Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pinetop Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1407586852
  NPD tax ID

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1578294153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 E WHITE MOUNTAIN BLVD # 5",
            "address_2": "BLVD 5",
            "city": "PINETOP",
            "state": "AZ",
            "postal_code": "85935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "674 E WHITE MOUNTAIN BLVD # 5",
            "address_2": "BLVD 5",
            "city": "PINETOP",
            "state": "AZ",
            "postal_code": "85935",
            "telephone_number": "207-409-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINETOP BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "NYIRAKANYANA",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-409-6515"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly J Marbello, PHARM.D.
• Michael B Hall PLLC
• Morada Behavioral Health Center
• Mayra Patricia Morales
• Thomas Samuel Paxman, DO
• Pinetop Medical Associates LTD (Blue Ridge Regional Clinic)
• Pinetop Treatment Center LLC
• Pinetop Volunteer Fire District
• R Alan Lee OD PC
• Patricia M Rafferty, OTR/L

• Mental Health Clinic/Center (Including Community Mental Health Center) in Pinetop, AZ
• Providers in Pinetop, 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 Jun 23, 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.