NPIMap

Organization Active NPI

Edventures Group Pinon

Doing business as khadjenoury LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Pinon, AZ
National Provider Identifier
1659690287
Registry record updated May 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
EDVENTURES GROUP PINON
Doing business as
khadjenoury LLC
Practice address
1 Mile North of Pinon Navajo RT Hwy 41
Pinon, AZ 86510
Phone
(520) 907-6890
Fax
(801) 930-9134
NPI assigned
May 21, 2010
Last updated
May 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2010

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

Authorized official

Name
Mr. Siamak Khadjenoury
Title
Ceo
Phone
(520) 907-6890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

1 Mile North of Pinon Navajo RT Hwy 41
Pinon, AZ 86510

Mailing address

8848 Willow Hills CT
Sandy, UT 84093-1889
Phone (520) 907-6890

Other names 1

  • khadjenoury LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edventures Group10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274400000000",
    "number": "1659690287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8848 WILLOW HILLS CT",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840931889",
            "telephone_number": "520-907-6890",
            "fax_number": "801-930-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MILE NORTH OF PINON NAVAJO RT HWY 41",
            "city": "PINON",
            "state": "AZ",
            "postal_code": "86510",
            "telephone_number": "520-907-6890",
            "fax_number": "801-930-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDVENTURES GROUP PINON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2010-05-21",
        "status": "A",
        "authorized_official_last_name": "KHADJENOURY",
        "authorized_official_first_name": "SIAMAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-907-6890",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "khadjenoury LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pinon, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; 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.