BLACKBRIDGE BEHAVIORAL HEALTH LLC NPI 1376456533

NPI Information

  • NPI: 1376456533
  • Provider Name: BLACKBRIDGE BEHAVIORAL HEALTH LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • :
  • Address: 15811 W COCOPAH ST
    GOODYEAR, AZ
    ZIP 85338
  • Phone: (480) 912-0555

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NPI Details

BLACKBRIDGE BEHAVIORAL HEALTH LLC is a mental health (including community mental health center) clinic center in Goodyear, AZ. BLACKBRIDGE BEHAVIORAL HEALTH LLC NPI is 1376456533. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

15811 W COCOPAH ST
GOODYEAR, AZ
ZIP 85338-413
Phone: (480) 912-0555

The provider's authorized official is Serah B Mukoko .
The authorized official title is Owner/administrator and has the following contact phone number (480) 900-5277.

The enumeration date for this NPI number is 9/28/2026 and was last updated on 10/7/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
4261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo

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: 11/21/2025

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