Active NPI
Convicted Comeback
- Community/Behavioral Health Agency
- Glendale, AZ
National Provider Identifier
1619835204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.