NPIMap

Organization Active NPI

New Merveille LLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1710749288
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NEW MERVEILLE LLC
Practice address
2375 E Camelback Rd Ste 600
Phoenix, AZ 85016-3493
Phone
(817) 707-2798
NPI assigned
Jan 29, 2024
Last updated
Mar 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Desire NkomeziNPI 1669234779
Title
Owner
Phone
(817) 707-2798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Substance Abuse Rehabilitation Facility 324500000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2375 E Camelback Rd Ste 600
Phoenix, AZ 85016-3493

Mailing address

4821 N 108TH Ave
Phoenix, AZ 85037-5471
Phone (817) 707-2798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240312004016 AZ Part B Supplier - Clinic/Group Practice 1456797414 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory
Tax ID family
New Merveille LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1710749288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 N 108TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375471",
            "telephone_number": "817-707-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 E CAMELBACK RD STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163493",
            "telephone_number": "817-707-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MERVEILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "NKOMEZI",
        "authorized_official_first_name": "DESIRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-707-2798"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.