P.R.I.E. Behavioral Health, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

P.R.I.E. BEHAVIORAL HEALTH, LLC

Practice address

42080 W Somerset Dr
Maricopa, AZ 85138-3277

Phone

(336) 816-0343

NPI assigned

Aug 11, 2020

Organization subpart

No

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

Authorized official

Name

Constance B Polite

Title

Co-Owner

Phone

(336) 816-0343

Specialties & licenses 5

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1679184899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42080 W SOMERSET DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851383277",
            "telephone_number": "336-816-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42080 W SOMERSET DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851383277",
            "telephone_number": "336-816-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.R.I.E. BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "POLITE",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "336-816-0343"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sharenote.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "42080 W Somerset Dr",
            "city": "Maricopa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851383277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.