LEGACY BEHAVIORAL HEALTH,LLC (NPI# 1649688896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649688896 |
| Entity Type | Organization |
| Organization Name | LEGACY BEHAVIORAL HEALTH,LLC |
| Practice Address |
2224 W Sax Canyon Ct Anthem AZ 85086-3657 |
| Practice Telephone | 5204005709 |
| Practice Fax Number | 6237761776 |
| Mailing Telephone | 5204005709 |
| Mailing Fax Number | 6237761776 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |
| Authorized Official Name | MR. CHRIS ALAN BANKEN (CEO/FOUNDER) |
| Authorized Official Telephone | 5204005709 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 347C00000X | Private Vehicle | Transportation Services | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
2224 W SAX CANYON CT |
| City | ANTHEM |
| State | AZ |
| Zip Code | 85086-3657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097703 | Cindy Ryanto | Pharmacist | 39508 W Daisy Mountain Dr, Phoenix, AZ 85086 | 2020-09-15 |
| 1912559857 | Cathey Michelle Allen | Massage Therapist | 39006 N 11th Ave, Phoenix, AZ 85086 | 2019-07-11 |
| 1174000871 | Anthem Eye Group Pllc | Optometrist | 4205 W Anthem Way #101, Anthem, AZ 85086 | 2018-07-25 |
| 1366982449 | Angela Ann Childs | Registered Nurse | 42104 N Venture Dr Ste D118, Anthem, AZ 85086 | 2017-03-08 |
| 1144772054 | Joe Bezerra | Specialist | 39818 N Bell Meadow Trl, Phoenix, AZ 85086 | 2016-10-26 |
| 1669821252 | Arizona Procedural Center | Clinic/Center | 3655 West Anthem Way, Suite 109 Box 272, Athem, AZ 85086 | 2016-06-06 |
| 1124499280 | Shane Carr | Physical Therapist | 39716 N 7th St, Phoenix, AZ 85086 | 2015-10-15 |
| 1790174167 | Kelly Christine Collins | Dermatology | 42211 N 41st Dr. #a109, Phoenix, AZ 85086 | 2015-01-22 |
| 1174953913 | Sung Ae Lee | Radiology | 820 W. Ravina Lane, Anthem, AZ 85086 | 2013-11-14 |
| 1881034080 | Bryan Michael Hays | Dentist | 40411 N Capra Way, Anthem, AZ 85086 | 2013-07-02 |
| Find all providers in zip 85086 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598253 | Pinnacle Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 45369 W Horse Mesa Rd, Maricopa, AZ 85139-9128 | 2020-11-03 |
| 1649878687 | Ayobami Noheem Agoro | Community Based Residential Treatment Facility, Mental Illness | 12362 W Joblanca Rd, Avondale, AZ 85323-3130 | 2020-10-13 |
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1144835968 | Jfox II LLC | Community Based Residential Treatment Facility, Mental Illness | 5327 E Enrose Cir, Mesa, AZ 85205-5489 | 2020-09-09 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1952913998 | Vema Corporation | Community Based Residential Treatment Facility, Mental Illness | 12701 N 79th Dr, Peoria, AZ 85381-9049 | 2020-08-20 |
| 1720698509 | Lyddia Getaweru | Community Based Residential Treatment Facility, Mental Illness | 2767 W Peggy Dr, Queen Creek, AZ 85142-6686 | 2020-08-05 |
| 1689284531 | Brain Solutions Pllc | Community Based Residential Treatment Facility, Mental Illness | 4555 S Maverick Ct, Gilbert, AZ 85297-9532 | 2020-08-05 |
| 1548879950 | C&j Care Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4418 W Darrel Rd, Laveen, AZ 85339-6222 | 2020-07-31 |
| 1295353019 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 2840 S Chaparral Blvd, Gilbert, AZ 85295-7675 | 2020-07-08 |
| 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.