GPS Prescott Opco, LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

GPS PRESCOTT OPCO, LLC

Doing business as

Medical Behavioral Hospital of Northern Arizona

Practice address

181 Whipple St
Prescott, AZ 86301-1705

Phone

(928) 227-3424

NPI assigned

Oct 29, 2019

Organization subpart

No

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

Authorized official

Name

Christy Gilbert

Title

President and Coo

Phone

(574) 277-2630

Specialties & licenses 1

Addresses

Other names 1

• Medical Behavioral Hospital of Northern Arizona Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 034036

Legal name

MEDICAL BEHAVIORAL HOSPITAL OF NORTHERN ARIZONA, L

Certification status

Terminated Voluntary: merger or closure, Dec 5, 2022

Provider type (POS)

Hospital – Psychiatric

Participating since

Jun 16, 2020

Last certification

Oct 5, 2021

Beds

24

Ownership / control type

Private (for profit)

Facility address

181 Whipple Street
Prescott, AZ 86301

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1861036386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011705",
            "telephone_number": "928-227-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011705",
            "telephone_number": "928-227-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GPS PRESCOTT OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "PRESIDENT AND COO",
        "authorized_official_telephone_number": "574-277-2630"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Behavioral Hospital of Northern Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Warren G Goodman, MD
• Helen Goodrum, ROLFER, BCTMB
• Goodwin Street Medical Supply LLC
• Bevan Gottlieb, LISAC
• Nicole Clara Gourley
• Grace & Peace Counseling, LLC
• Lisa Ann Graham, M.D.
• Cary Eugene Graller, LMT
• Damon John Grandy, PT, DPT
• Granite Mountain Health LLC

• Psychiatric Hospital in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Psychiatric Hospital in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.