Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

IDEAL TREATMENT CENTER LLC
NPI 1336837616
Clinic/Center - Multi-Specialty in Phoenix, AZ

Active since April 25, 2023CLIA 03D2319779 · Waiver
1717 W NORTHERN AVE STE 107, PHOENIX, AZ 85021(602) 612-2305 Get Directions Write a Review

NPPES record last updated: June 19, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2025, Aug 19, 2024, Sep 7, 2023 (3 updates tracked since 2023).

About Ideal Treatment Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDEAL TREATMENT CENTER LLC (NPI 1336837616) is a healthcare organization registered as a multi-specialty in Phoenix, Arizona and active in the NPI registry since April 2023. The organization holds a CLIA Waiver certificate valid through March 5, 2027 and lists Aimee Uwimana, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1336837616
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameIDEAL TREATMENT CENTER LLC
Location Address1717 W NORTHERN AVE STE 107Phoenix, AZ 85021-5400
Mailing Address1717 W Northern Ave Ste 107Phoenix, AZ 85021-5400 · (602) 612-2305
Organization SubpartNo
Authorized OfficialAimee UwimanaNurse Practitioner · (602) 399-0134
Enumeration DateApril 25, 2023
Last NPPES UpdateJune 19, 20263 updates tracked since enumeration
NPPES CertifiedJune 19, 2026
NPI 1336837616 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1717 W NORTHERN AVE STE 107, Phoenix, AZ 85021

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2319779

Ideal Treatment Center LLC · Phoenix, AZ
Active · expires Mar 5, 2027
CLIA Number03D2319779
Laboratory TypeComp. Outpatient Rehab Facility
Certificate Effective DateMarch 6, 2025
Certificate Expiration DateMarch 5, 2027
Laboratory DirectorAimee Uwimana
Laboratory Phone(602) 800-9056
Laboratory LocationIdeal Treatment Center LLC1717 W Northern Ave Ste 116, Phoenix, AZ 85021
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Mental Health (Including Community Mental Health Center))
1717 W NORTHERN AVE STE 107
PHOENIX, AZ 85021
Nurse Practitioner
1717 W NORTHERN AVE STE 107
PHOENIX, AZ 85021

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ideal Treatment Center LLC's NPI number?

The NPI number for Ideal Treatment Center LLC is 1336837616. It was assigned to this organization in the NPPES registry on April 25, 2023.

Where is Ideal Treatment Center LLC located?

Ideal Treatment Center LLC is located at 1717 W Northern Ave Ste 107, Phoenix, AZ 85021. The listed phone number is (602) 612-2305.

What is Ideal Treatment Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Ideal Treatment Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2319779) is associated with this NPI, valid through March 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ideal Treatment Center LLC accept?

Health plans from Blue Cross Blue Shield of Arizona list Ideal Treatment Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ideal Treatment Center LLC was last updated on June 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 48 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.