PRIDE BEHAVIORAL HEALTH (NPI# 1134549579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134549579 |
| Entity Type | Organization |
| Organization Name | PRIDE BEHAVIORAL HEALTH |
| Practice Address |
1041 S Lebaron Mesa AZ 85210-3630 |
| Mailing Address |
2487 S Gilbert Rd Suite 106-180 Gilbert AZ 85295-8899 |
| Practice Telephone | 4807884628 |
| Practice Fax Number | 8668120853 |
| Mailing Telephone | 4807884628 |
| Mailing Fax Number | 8668120853 |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2015-12-08 |
| Authorized Official Name | REED T GUNNELL (OWNER) |
| Authorized Official Telephone | 4807884628 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 922548 | 05 |
| Street Address |
1041 S LEBARON |
| City | MESA |
| State | AZ |
| Zip Code | 85210-3630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972553360 | Lana J. Peterson | Nurse Practitioner | 1041 S Lebaron, Mesa, AZ 85210-3630 | 2006-05-10 |
| 1144452988 | Heritage Life Center LLC | Assisted Living Facility | 1041 S Lebaron, Mesa, AZ 85210-3630 | 2009-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548653942 | Latosha Moorehead | Registered Nurse | 310 S Extension Rd, Mesa, AZ 85210-1292 | 2015-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996617 | Audu Thomas Seriki | Registered Nurse | 2539 W Spencer Run, Phoenix, AZ 85041-2927 | 2020-09-08 |
| 1588177075 | Kathleen Hornick | Registered Nurse | 3309 W Athenee Ct, Tucson, AZ 85746-1076 | 2017-11-07 |
| 1265852818 | Paulette Carol Compton | Registered Nurse | 10755 N 118th Way, Scottsdale, AZ 85259-4113 | 2014-04-22 |
| 1487076311 | Vicki Hervert | Registered Nurse | 5351 N Blue Bonnet Rd, Tucson, AZ 85745-9494 | 2014-01-12 |
| 1396852737 | Susan Dale Markovich | Registered Nurse | 1601 W. St . Mary's Rd., Tucson, AZ 85745-2623 | 2006-08-23 |
| 1386669885 | Darren J Hammergren | Registered Nurse | 5700 E. Pima St., #1, Tucson, AZ 85712 | 2006-07-13 |
| 1457963852 | Alexandria Penner | Registered Nurse | 1305 N Martin Ave, Tucson, AZ 85721-0001 | 2020-08-18 |
| 1245798909 | Amanda Elizabeth Martinez | Registered Nurse | 6950 E Golf Links Rd, Tucson, AZ 85730-1017 | 2019-03-12 |
| 1225579808 | Dennis George Demers | Registered Nurse | 4755 Campus Dr, Sierra Vista, AZ 85635-2449 | 2017-03-15 |
| 1568905073 | Stuart Haiken | Registered Nurse | 39580 S Lago Del Oro Pkwy, Tucson, AZ 85739-1091 | 2016-12-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.