OrganizationActive
Providence Behavioral Health LLC
NPI 1700527637 · Mental Illness Community Based Residential Treatment Facility · Tolleson, AZ
Provider details
- NPI number
- 1700527637
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Funmilola Ogunla, Director(602) 628-2266
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
8714 W Pioneer St
Tolleson, AZ 85353-8618
Phone: (602) 628-2266
Street-level locationGet directions
Mailing address
8714 W Pioneer St
Tolleson, AZ 85353-8618
Registry dates
- Enumerated
- 2022-04-05
- Last updated
- 2022-04-05
- Certified
- 2022-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.