Organization Active NPI

Convicted Comeback

  • Community/Behavioral Health Agency
  • Glendale, AZ
National Provider Identifier
1619835204
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CONVICTED COMEBACK
Practice address
5955 W Peoria Ave Unit 5343
Glendale, AZ 85312-1015
Phone
(623) 309-0052
NPI assigned
Jan 12, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Ms. Kristin Kline
Title
Co Founder
Phone
(623) 309-0052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

5955 W Peoria Ave Unit 5343
Glendale, AZ 85312-1015

Mailing address

5955 W Peoria Ave Unit 5343
Glendale, AZ 85312-1015
Phone (623) 309-0052

National Provider Directory

National Provider Directory

Locations

5955 W Peoria Ave
Unit 5343
Glendale, AZ 85312
Phone (623) 309-0052

NPI Registry JSON

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1619835204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 W PEORIA AVE UNIT 5343",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853121015",
            "telephone_number": "623-309-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 W PEORIA AVE UNIT 5343",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853121015",
            "telephone_number": "623-309-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVICTED COMEBACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "CO FOUNDER",
        "authorized_official_telephone_number": "623-309-0052",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.