NPIMap

Organization Active NPI

Successful Journeys, LLC

Doing business as Successful Journeys IV

  • Mental Illness Community Based Residential Treatment Facility
  • Glendale, AZ
National Provider Identifier
1912652652
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SUCCESSFUL JOURNEYS, LLC
Doing business as
Successful Journeys IV
Practice address
12224 N 45TH LN
Glendale, AZ 85304-2312
Phone
(623) 293-8022
Fax
(602) 693-0628
NPI assigned
Feb 21, 2022
Last updated
Feb 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Sekou Jackson, MA, MPA
Title
Program Coordinator
Phone
(623) 293-7792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

12224 N 45TH LN
Glendale, AZ 85304-2312

Mailing address

20969 W Thomas Rd
Buckeye, AZ 85396-1645
Phone (623) 293-8022

Other names 1

  • Successful Journeys IV Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Successful Journeys LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1912652652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20969 W THOMAS RD",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853961645",
            "telephone_number": "623-293-8022",
            "fax_number": "602-693-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12224 N 45TH LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042312",
            "telephone_number": "623-293-8022",
            "fax_number": "602-693-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUCCESSFUL JOURNEYS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SEKOU",
        "authorized_official_title_or_position": "PROGRAM COORDINATOR",
        "authorized_official_telephone_number": "623-293-7792",
        "authorized_official_credential": "MA, MPA"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Successful Journeys IV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.