Organization Active NPI

Dos Abuelos Arizona, LLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1720512908
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DOS ABUELOS ARIZONA, LLC
Practice address
3118 W Thomas Rd
Suite 712
Phoenix, AZ 85017-5308
Phone
(602) 388-4017
NPI assigned
Apr 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Authorized official

Name
Tyrae J WordNPI 1598137242
Title
Corporate Administrator
Phone
(602) 388-4017

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3118 W Thomas Rd
Suite 712
Phoenix, AZ 85017-5308

Mailing address

3118 W Thomas Rd Ste 712
Phoenix, AZ 85017-5308
Phone (602) 388-4017

Other names 1

  • El Paso Family mentoring and Counseling Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171009003412 AZ Part B Supplier - Clinic/Group Practice 2860767324 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

3118 W Thomas Rd
Ste 712
Phoenix, AZ 85017
Phone (602) 388-4017

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771459200000",
    "number": "1720512908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3118 W THOMAS RD STE 712",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175308",
            "telephone_number": "602-388-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3118 W THOMAS RD",
            "address_2": "SUITE 712",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175308",
            "telephone_number": "602-388-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOS ABUELOS ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-14",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A",
        "authorized_official_last_name": "WORD",
        "authorized_official_first_name": "TYRAE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CORPORATE ADMINISTRATOR",
        "authorized_official_telephone_number": "602-388-4017"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Paso Family mentoring and Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 19, 2026; 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.