South Phoenix Integrity House LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTH PHOENIX INTEGRITY HOUSE LLC

Practice address

1612 E Southern Ave
Phoenix, AZ 85040-3534

Phone

(520) 907-1437

NPI assigned

Feb 20, 2023

Last updated

Feb 20, 2023By 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

Mara L CarlosNPI 1346952132

Title

Owner

Phone

(520) 907-1437

Specialties & licenses 1

Addresses

Locations

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.

• Mara Lena Carlos

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
  • NPI 1346952132
  NPD Authorized official

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1619675626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 E SOUTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850403534",
            "telephone_number": "520-907-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 E SOUTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850403534",
            "telephone_number": "520-907-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PHOENIX INTEGRITY HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-19",
        "status": "A",
        "authorized_official_last_name": "CARLOS",
        "authorized_official_first_name": "MARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-907-1437"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.