NPIMap

Organization Active NPI

Summit Behavioral Health of Arizona

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Prescott Valley, AZ
National Provider Identifier
1669002903
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SUMMIT BEHAVIORAL HEALTH OF ARIZONA
Doing business as
Summit Behavioral Health of Arizona
Practice address
8183 E Florentine Rd
Prescott Valley, AZ 86314-8481
Phone
(928) 756-0694
NPI assigned
Jan 24, 2020
Organization subpart
Yes
Parent organization
SUMMIT BEHAVIORAL HEALTH OF ARIZONAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Authorized official

Name
Benjamin T Isenberg
Title
Ceo
Phone
(928) 710-7021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

8183 E Florentine Rd
Prescott Valley, AZ 86314-8481

Mailing address

8183 E Florentine Rd
Prescott Valley, AZ 86314-8481
Phone (928) 756-0694

Other names 1

  • Summit Behavioral Health of Arizona Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summit Behavioral Health of Az LLC3 organizations share this tax ID, including this one
Part of
Summit Behavioral Health of Az LLC

Other organizations with this tax ID 2

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1669002903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8183 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148481",
            "telephone_number": "928-756-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8183 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148481",
            "telephone_number": "928-756-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT BEHAVIORAL HEALTH OF ARIZONA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT BEHAVIORAL HEALTH OF ARIZONA",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "ISENBERG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-710-7021"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Behavioral Health of Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.