Organization Active NPI

Grant Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1912763780
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GRANT HEALTH AND WELLNESS LLC
Practice address
208 W Lester St
Tucson, AZ 85705-6552
Phone
(520) 233-4585
NPI assigned
Feb 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Mrs. Titilayo Grant, NPNPI 1134698566
Title
Ceo
Phone
(602) 492-4992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

208 W Lester St
Tucson, AZ 85705-6552

Mailing address

3015 S Bell PL
Chandler, AZ 85286-2496
Phone (602) 492-4992

Other names 1

  • Grant Wellness Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240830002792 AZ Part B Supplier - Clinic/Group Practice 2769921980 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

208 W Lester St
Tucson, AZ 85705
Phone (520) 233-4585

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1912763780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 S BELL PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852862496",
            "telephone_number": "602-492-4992",
            "fax_number": "480-612-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 W LESTER ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857056552",
            "telephone_number": "520-233-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "TITILAYO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-492-4992",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Wellness Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Grant Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.