Mountain Dew Behavioral Health PLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

50979 Issued in AZ

Legal business name

MOUNTAIN DEW BEHAVIORAL HEALTH PLC

Practice address

6700 N Oracle Rd
Suite 119
Tucson, AZ 85704-7732

Phone

(520) 389-8468

NPI assigned

Apr 30, 2016

Last updated

Mar 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Abanishe, MDNPI 1992053573

Title

Chairman/Medical Director

Phone

(917) 376-7720

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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.

• James Olushola Abanishe, M.D

  • Psychiatry Physician
  • New New, NY
  • NPI 1992053573

  AZ

  Medicare reassignment NPD Authorized official
• Nancy Euegina Williams, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Tempe, AZ
  • NPI 1245255637
  NPD (past)

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

{
    "created_epoch": "1461974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1790130482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N ORACLE RD",
            "address_2": "SUITE 119",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047732",
            "telephone_number": "520-389-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN DEW BEHAVIORAL HEALTH PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-30",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "ABANISHE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHAIRMAN/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "917-376-7720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AZ",
            "license": "50979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mount Lemmon Healthcare LLC (Tucson Recovery Villa Maria)
• Mount Lemmon Healthcare LLC
• Mount Lemmon Healthcare LLC (Villa Maria Care Center (ALF))
• Mount Lemmon Healthcare LLC (Villa Maria Detox)
• Mount Lemmon Healthcare LLC (Villa Maria Care Center Outpatient Therapy)
• Mountain Medical Management, LLC
• Mountain Osteopathic, PLLC
• Mountain Springs Community Services LLC
• Mountain View Gastroenterology, PC
• Mountain View Mental Health LLC

• Adult Mental Health Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.