NPIMap

Organization Active NPI

Lavie Behavioral Home

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1962162990
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
LAVIE BEHAVIORAL HOME
Doing business as
Lavie behavioral Home
Practice address
3043 W Butler Dr
Phoenix, AZ 85051-3940
Phone
(602) 314-6963
NPI assigned
Dec 17, 2021
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Gaby NgoundjoNPI 1669130357
Title
Owner
Phone
(480) 249-9851

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3043 W Butler Dr
Phoenix, AZ 85051-3940

Mailing address

3043 W Butler Dr
Phoenix, AZ 85051-3940
Phone (602) 314-6963

Other names 1

  • Lavie behavioral Home Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL computer Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1962162990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 W BUTLER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850513940",
            "telephone_number": "602-314-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 W BUTLER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850513940",
            "telephone_number": "602-314-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVIE BEHAVIORAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "NGOUNDJO",
        "authorized_official_first_name": "GABY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-249-9851"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "computer",
            "affiliation": "N",
            "endpointDescription": "computer",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3043 W Butler Dr",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850513940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lavie behavioral Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.