NPIMap

Organization Active NPI

Successful Journeys, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Chandler, AZ
National Provider Identifier
1760138101
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SUCCESSFUL JOURNEYS, LLC
Practice address
1518 W Comstock Dr
Chandler, AZ 85224-1855
Phone
(623) 293-8022
Fax
(602) 693-0628
NPI assigned
Feb 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Sekou Jackson, MA, MPA
Title
Program Coordinator
Phone
(623) 293-7792

Specialties & licenses 1

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

Addresses

Primary practice location

1518 W Comstock Dr
Chandler, AZ 85224-1855

Mailing address

20969 W Thomas Rd
Buckeye, AZ 85396-1645
Phone (623) 293-7792

Other identifiers 1

IdentifierTypeStateIssuer
1518MedicaidAZ

Other names 1

  • Successful Journeys V Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dr.david@sjicare.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Successful Journeys LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1760138101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20969 W THOMAS RD",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853961645",
            "telephone_number": "623-293-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 W COMSTOCK DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241855",
            "telephone_number": "623-293-8022",
            "fax_number": "602-693-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSFUL JOURNEYS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SEKOU",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "623-293-7792",
        "authorized_official_credential": "MA, MPA"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.david@sjicare.com",
            "affiliation": "N",
            "endpointDescription": "MD/Owner has access to mailbox",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1518 W Comstock Dr",
            "city": "Chandler",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852241855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Successful Journeys V",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.