NPIMap

Organization Active NPI

Changepoint Integrated Health

Doing business as ChangePoint Integrated Health-CSU

  • Community/Behavioral Health Agency
  • Lakeside, AZ
National Provider Identifier
1841836285
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHANGEPOINT INTEGRATED HEALTH
Doing business as
ChangePoint Integrated Health-CSU
Practice address
1920 West Commerce Dr
Lakeside, AZ 85929
Phone
(928) 368-4110
Fax
(928) 892-5828
NPI assigned
Nov 20, 2019
Last updated
Nov 20, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
CHANGEPOINT INTEGRATED HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Authorized official

Name
Michele Hospodka
Title
Billing / Credentialing
Phone
(928) 537-2951

Specialties & licenses 1

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

Addresses

Primary practice location

1920 West Commerce Dr
Lakeside, AZ 85929

Mailing address

1801 W Deuce of Clubs Ste 100
Show Low, AZ 85901-2704
Phone (928) 537-2951

Other identifiers 1

IdentifierTypeStateIssuer
786444MedicaidAZ

Other names 1

  • ChangePoint Integrated Health-CSU Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Centers Inc8 organizations share this tax ID, including this one
Part of
Community Counseling Centers Inc

Other organizations with this tax ID 7

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

Locations

1801 W Deuce of Clubs
Ste 100
Show Low, AZ 85901
Phone (928) 368-4110

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1841836285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W DEUCE OF CLUBS STE 100",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859012704",
            "telephone_number": "928-537-2951",
            "fax_number": "928-892-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 WEST COMMERCE DR",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "85929",
            "telephone_number": "928-368-4110",
            "fax_number": "928-892-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGEPOINT INTEGRATED HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHANGEPOINT INTEGRATED HEALTH",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "HOSPODKA",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "BILLING / CREDENTIALING",
        "authorized_official_telephone_number": "928-537-2951"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786444",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChangePoint Integrated Health-CSU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeside, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.