Next Level Vitality Llc - Medicare Mental Health Clinic in San Tan Valley, AZ

Next Level Vitality Llc is a medicare enrolled mental health clinic (Clinic/center - Mental Health (including Community Mental Health Center)) in San Tan Valley, Arizona. The current practice location for Next Level Vitality Llc is 26 W Brahman Blvd, San Tan Valley, Arizona. For appointments, you can reach them via phone at (619) 366-1546. The mailing address for Next Level Vitality Llc is 26 W Brahman Blvd, San Tan Valley, Arizona and phone number is (619) 366-1546.

Next Level Vitality Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1407402316. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (619) 366-1546.

Contact Information

Next Level Vitality Llc
26 W Brahman Blvd
San Tan Valley
AZ 85143-4852
(619) 366-1546
Not Available

Mental Health Clinic Profile

Full NameNext Level Vitality Llc
SpecialityClinic/Center
Location26 W Brahman Blvd, San Tan Valley, Arizona
Authorized Official Name and PositionTia Ross (OWNER)
Authorized Official Contact6193661546
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Next Level Vitality Llc
26 W Brahman Blvd
San Tan Valley
AZ 85143-4852

Ph: (619) 366-1546
Next Level Vitality Llc
26 W Brahman Blvd
San Tan Valley
AZ 85143-4852

Ph: (619) 366-1546

NPI Details:

NPI Number1407402316
Provider Enumeration Date08/15/2019
Last Update Date09/22/2022
Certification Date09/22/2022

Medicare PECOS Information:

Medicare PECOS PAC ID9739573494
Medicare Enrollment IDO20220223002840

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Medical Identifiers

Medical identifiers for Next Level Vitality Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407402316NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM0801XClinic/center - Mental Health (including Community Mental Health Center) (* (Not Available))Primary
320800000XCommunity Based Residential Treatment Facility, Mental Illness (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Next Level Vitality Llc acts as a billing entity for following providers:
Provider NameLillian L Espinoza
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1841643277
PECOS PAC ID: 2567856156
Enrollment ID: I20220422000540

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