NPIMap

Organization Active NPI

Khadjenoury LLC

  • Community/Behavioral Health Agency
  • Chinle, AZ
National Provider Identifier
1790937548
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KHADJENOURY LLC
Practice address
Hwy 59 and HC 61 P.O. 5050-PTT
Edventures Program C/O Rough Rock High School
Chinle, AZ 86503
Phone
(520) 907-6890
Fax
(801) 944-2940
NPI assigned
Oct 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Mr. Siamak Khadjenoury
Title
Ceo
Phone
(520) 907-6890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

Hwy 59 and HC 61 P.O. 5050-PTT
Edventures Program C/O Rough Rock High School
Chinle, AZ 86503

Mailing address

8848 Willow Hills CT
Sandy, UT 84093-1889
Phone (520) 907-6890

Other names 1

  • Edventures Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edventures Group10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

5050 HC 61
Chinle, AZ 86503
Phone (520) 907-6890

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1790937548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8848 WILLOW HILLS CT",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840931889",
            "telephone_number": "520-907-6890",
            "fax_number": "801-944-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 59 AND HC 61 P.O. 5050-PTT",
            "address_2": "EDVENTURES PROGRAM C/O ROUGH ROCK HIGH SCHOOL",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "520-907-6890",
            "fax_number": "801-944-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHADJENOURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "KHADJENOURY",
        "authorized_official_first_name": "SIAMAK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-907-6890",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edventures Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chinle, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.