MEDICARE: KRYTEN HOLDINGS 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1962352336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRYTEN HOLDINGS LLC

Provider Business Mailing Address
First Line	:	3409 N 7TH AVE # 2070
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3635
Country	:	US
Telephone Number	:	520-595-5758
Fax Number	:	520-655-4232

Provider Business Practice Location Address
First Line	:	11024 N 28TH DR STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4378
Country	:	US
Telephone Number	:	520-595-5758
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN WILLIAM GARRETT
Credential	:
Telephone Number	:	520-655-3825

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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