NPIMap

Organization Active NPI

Brighter Heights Arizona, LLC Dba Prescott House

  • Mental Illness Community Based Residential Treatment Facility
  • Prescott Valley, AZ
National Provider Identifier
1780777540
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH-3650 Issued in AZ
Legal business name
BRIGHTER HEIGHTS ARIZONA, LLC DBA PRESCOTT HOUSE
Practice address
4001 North Catherine Drive
Prescott Valley, AZ 86314
Phone
(928) 775-7118
NPI assigned
Oct 2, 2006
Last updated
Jul 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Authorized official

Name
Ms. Brooke Wilson
Title
Senior Credentialing Specialist
Phone
(928) 910-7644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH-3650 AZ Primary

Addresses

Primary practice location

4001 North Catherine Drive
Prescott Valley, AZ 86314

Mailing address

2517 N Great Western Dr.
Suite P
Prescott Valley, AZ 86314-2597
Phone (928) 777-3280

Other identifiers 5

IdentifierTypeStateIssuer
560284MedicaidAZ
BH3650OtherAZLIC#
BH-3650OtherAZLIC #
560284OtherAZAHCCCS ID
BH4980OtherAZLIC #

Other names 1

  • SequelCare of Arizona, LLC dba Prescott House Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Brighter Heights Arizona LLC Dba Blue Ridge Manor15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1780777540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 N GREAT WESTERN DR.",
            "address_2": "SUITE P",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142597",
            "telephone_number": "928-777-3280",
            "fax_number": "928-227-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 NORTH CATHERINE DRIVE",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "86314",
            "telephone_number": "928-775-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTER HEIGHTS ARIZONA, LLC DBA PRESCOTT HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "928-910-7644",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560284",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC#",
            "identifier": "BH3650",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC #",
            "identifier": "BH-3650",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS ID",
            "identifier": "560284",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC #",
            "identifier": "BH4980",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SequelCare of Arizona, LLC dba Prescott House",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.