Healthcare Provider Details

I. General information

NPI: 1376367169
Provider Name (Legal Business Name): NEXSTEP TEEN ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9937 E BELL RD
SCOTTSDALE AZ
85260-2524
US

IV. Provider business mailing address

9937 E BELL RD
SCOTTSDALE AZ
85260-2524
US

V. Phone/Fax

Practice location:
  • Phone: 480-485-3424
  • Fax: 480-977-2569
Mailing address:
  • Phone: 480-805-8900
  • Fax: 480-977-2569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. TAYLOR WOOD
Title or Position: ADMINISTRATOR
Credential:
Phone: 623-256-4184