The Crusader Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE CRUSADER CENTER

Practice address

4480 W Peoria Ave Ste 105
Glendale, AZ 85302-2022

Phone

(602) 271-2624

NPI assigned

May 16, 2023

Organization subpart

No

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

Authorized official

Name

Kenyatta Fletcher

Title

Owner/Administrator

Phone

(602) 271-2624

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1780375287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 W PEORIA AVE STE 105",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022022",
            "telephone_number": "602-271-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 W PEORIA AVE STE 105",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022022",
            "telephone_number": "602-271-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CRUSADER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "KENYATTA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "602-271-2624"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.