MEDICARE: COLIBRI VISTAS MENTAL HEALTH, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1619823846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLIBRI VISTAS MENTAL HEALTH, LLC.

Provider Business Mailing Address
First Line	:	24871 S ELLSWORTH RD STE 100-162
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-1574
Country	:	US
Telephone Number	:	480-861-7784
Fax Number	:

Provider Business Practice Location Address
First Line	:	26311 S 194TH ST
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-5848
Country	:	US
Telephone Number	:	480-861-7784
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	TERESA ROBINSON
Credential	:	PMHNP
Telephone Number	:	480-861-7784

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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