Eagles Nest Thunderbird LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

EAGLES NEST THUNDERBIRD LLC

Practice address

540 E Thunderbird TRL
Phoenix, AZ 85042-8370

Phone

(602) 305-9599

Fax

(602) 268-4834

NPI assigned

Apr 10, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Barbara L Cobbs-McClure

Title

Assistant Director

Phone

(602) 570-9309

Specialties & licenses 1

Addresses

Other names 1

• eaglesnestThunderbird Doing business as

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1649965195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 E DOBBINS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850428500",
            "telephone_number": "602-568-1441",
            "fax_number": "602-268-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E THUNDERBIRD TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850428370",
            "telephone_number": "602-305-9599",
            "fax_number": "602-268-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES NEST THUNDERBIRD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "COBBS-MCCLURE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "602-570-9309",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eaglesnestThunderbird",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "eaglesnestThunderbird",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.