Performance Intensive Outpatient, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

PERFORMANCE INTENSIVE OUTPATIENT, LLC

Doing business as

Performance IOP, LLC

Practice address

9525 E Doubletree Ranch Rd Ste 105
Scottsdale, AZ 85258-5538

Phone

(480) 588-3745

NPI assigned

Mar 30, 2021

Organization subpart

No

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

Authorized official

Name

Benjamin Tyler Terrusa

Title

Member/Chief Administrative Officer

Phone

(818) 251-0123

Specialties & licenses 1

Addresses

Other names 1

• Performance IOP, LLC Doing business as

Locations

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624665600000",
    "number": "1861070260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9525 E DOUBLETREE RANCH RD STE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585538",
            "telephone_number": "480-588-3745",
            "fax_number": "480-809-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9525 E DOUBLETREE RANCH RD STE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585538",
            "telephone_number": "480-588-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE INTENSIVE OUTPATIENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A",
        "authorized_official_last_name": "TERRUSA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "MEMBER/CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "818-251-0123"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance IOP, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Performance IOP, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Periodonal Specialists

• Adult Mental Health Clinic/Center in Scottsdale, AZ
• Providers in Scottsdale, 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 Jun 26, 2021; 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.