Mindflex Outpatient Treatment Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MINDFLEX OUTPATIENT TREATMENT CENTER LLC

Practice address

5447 E 5TH St
Tucson, AZ 85711-2344

Phone

(602) 880-4214

NPI assigned

Feb 21, 2023

Organization subpart

No

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

Authorized official

Name

Bola Okougbo

Title

Owner

Phone

(602) 880-4214

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1649978347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5447 E 5TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112344",
            "telephone_number": "602-880-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5447 E 5TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112344",
            "telephone_number": "602-880-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFLEX OUTPATIENT TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "OKOUGBO",
        "authorized_official_first_name": "BOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-880-4214"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "OTC12289",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Tucson, AZ
• Providers in Tucson, 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 21, 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.