1487227070 NPI number — JOURNEY SOLUTIONS INC.

Table of content: (NPI 1487227070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487227070 NPI number — JOURNEY SOLUTIONS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOURNEY SOLUTIONS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487227070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 20712
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85036-0712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-387-5102
Provider Business Mailing Address Fax Number:
602-801-2770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 E WASHINGTON ST STE 102103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHOENIX
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85034-1162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
602-601-4231
Provider Business Practice Location Address Fax Number:
602-801-2770
Provider Enumeration Date:
07/21/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WINSTON
Authorized Official First Name:
APRIL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
602-387-5102

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 005311 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".