Family Life Behavioral Health LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FAMILY LIFE BEHAVIORAL HEALTH LLC

Practice address

4494 W Peoria Ave
Glendale, AZ 85302-2023

Phone

(623) 206-7541

NPI assigned

Feb 27, 2023

Organization subpart

No

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

Authorized official

Name

Markus Booker

Title

Owner

Phone

(623) 206-7541

Specialties & licenses 1

Addresses

Tax ID family

Family Life Behavioral Health 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.

• Family Life Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1043068455
  NPD tax ID

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1740989862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 W PEORIA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022023",
            "telephone_number": "623-206-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 W PEORIA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022023",
            "telephone_number": "623-206-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "MARKUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-206-7541"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Involvement Center, Inc
• Family Life Behavioral Health LLC
• Family Practice Associates, P.C.
• Brianna Fandialan
• Shu Zhen Fang
• Samantha Rose Fannin
• Emily Caroline Fanning, MD

• Community/Behavioral Health Agency in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.