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SUCCESSFUL JOURNEYS DAY PROGRAM LLC NPI 1003180746


NPI Information

NPI: 1003180746
Provider Name: SUCCESSFUL JOURNEYS DAY PROGRAM, LLC

Doing Business As: SUCCESSFUL JOURNEYS DAY PROGRAM

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
9950 W VAN BUREN ST
B135
AVONDALE, AZ
ZIP 85323
Phone: (623) 478-9400
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SUCCESSFUL JOURNEYS DAY PROGRAM, LLC is a mental health (including community mental health center) clinic center in Avondale, AZ. SUCCESSFUL JOURNEYS DAY PROGRAM, LLC NPI is 1003180746. The provider is registered as an organization entity type.
The provider Is Doing Business As Successful Journeys Day Program.

The provider's business location address is:

9950 W VAN BUREN ST
B135
AVONDALE, AZ
ZIP 85323-322
Phone: (623) 478-9400
Fax: (623) 478-9500

The provider's authorized official is Sekou Jackson .
The authorized official title is Clinical Director/coo and has the following contact phone number (623) 478-9400.

The enumeration date for this NPI number is 2/27/2012 and was last updated on 2/27/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)BH3967ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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