NPIMap

Organization Active NPI

Destiny Behavioral Health Residential Care, LLC 7

  • Mental Illness Community Based Residential Treatment Facility
  • Tolleson, AZ
National Provider Identifier
1639794522
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
DESTINY BEHAVIORAL HEALTH RESIDENTIAL CARE, LLC 7
Practice address
9915 W Wier Ave
Tolleson, AZ 85353-4429
Phone
(602) 384-8820
NPI assigned
Jun 16, 2020
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Mr. Funso Feyi Ogunla
Title
Director
Phone
(602) 384-8820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

9915 W Wier Ave
Tolleson, AZ 85353-4429

Mailing address

2911 S 87TH Dr # a
Tolleson, AZ 85353-8650
Phone (602) 384-8820

National Provider Directory

National Provider Directory
Tax ID family
Destiny Behavioral Health Residential Care LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1639794522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 S 87TH DR # A",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538650",
            "telephone_number": "602-384-8820",
            "fax_number": "877-288-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9915 W WIER AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853534429",
            "telephone_number": "602-384-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY BEHAVIORAL HEALTH RESIDENTIAL CARE, LLC 7",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "OGUNLA",
        "authorized_official_first_name": "FUNSO",
        "authorized_official_middle_name": "FEYI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-384-8820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolleson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.