NPIMap

Organization Active NPI

Paradise Valley Behavioral Heath Inna

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1750745196
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH4530 Issued in AZ
Legal business name
PARADISE VALLEY BEHAVIORAL HEATH INNA
Practice address
3015 E Gelding Dr
Phoenix, AZ 85032
Phone
(602) 400-2288
NPI assigned
Apr 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Authorized official

Name
David Gabriel Cardoso
Title
Director
Phone
(602) 400-2288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH4530 AZ Primary

Addresses

Primary practice location

3015 E Gelding Dr
Phoenix, AZ 85032

Mailing address

3015 E Gelding Dr
Phoenix, AZ 85032
Phone (602) 400-2288

Other identifiers 1

IdentifierTypeStateIssuer
BH4530OtherAZDEPARTMENT OF BEHAVIORAL HEALTH

National Provider Directory

National Provider Directory
Tax ID family
Paradise Valley Behavioral Heath Inna3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1750745196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 E GELDING DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-400-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 E GELDING DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-400-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE VALLEY BEHAVIORAL HEATH INNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "CARDOSO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-400-2288"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH4530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF BEHAVIORAL HEALTH",
            "identifier": "BH4530",
            "state": "AZ"
        }
    ],
    "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 Apr 12, 2016; 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.