THE HERITAGE BEHAVIORAL HEALTH HOME LLC (NPI# 1114536752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114536752 |
| Entity Type | Organization |
| Organization Name | THE HERITAGE BEHAVIORAL HEALTH HOME LLC |
| Practice Address |
3927 W Rovey Ave Phoenix AZ 85019-1633 |
| Practice Telephone | 6026753975 |
| Mailing Telephone | 9734522505 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | MS. KRISTEN SMITH (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 9732704676 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 00000000 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4132 W Purdue Ave, Phoenix, AZ 850511073 | 9732704676 |
| Street Address |
3927 W ROVEY AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85019-1633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964488 | Roger Beck Slice | Registered Nurse | 6331 N. 39th Ave., Phoenix, AZ 85019 | 2018-12-20 |
| 1093204687 | Patricia Enevy Gomez Jayme | Physical Therapist | 532 W Thomas Rd Suite 5, Phoenix, AZ 85019 | 2018-05-09 |
| 1396257762 | Shirley Ann Furlong | Licensed Practical Nurse | Alhambra School District No 68, 4510 N 37th Avenue, Phoenix, AZ 85019 | 2017-10-25 |
| 1508253014 | Benjamin Noel Zuniga | Dentist | 3542 W Camelback Rd, Phoenix, AZ 85019 | 2015-04-22 |
| 1063610475 | German Dobson Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | Thomas & 43rd Ave, Phoenix, AZ 85019 | 2007-07-06 |
| 1558489575 | Beverly Beierbach Wells | Speech-Language Pathologist | 3839 W Camelback Road, Phoenix, AZ 85019 | 2007-03-27 |
| 1497872600 | Josefa Almanza | Speech-Language Pathologist | 4006 W Osborn Rd, Phoenix, AZ 85019 | 2007-03-23 |
| 1760550024 | Steven C Chang | Dentist | 3608 W Camelback Rd, Phoenix, AZ 85019 | 2006-12-02 |
| 1891723623 | George Figueroa | Obstetrics & Gynecology | 3660 W. Bethany Home Road, Suite A, Phoenix, AZ 85019 | 2006-06-29 |
| 1881169704 | Janice Jinju Kim | Dentist | 3608 W Camelback Rd, Phoenix, AZ 85019 | 2018-10-07 |
| Find all providers in zip 85019 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1043846561 | Happy Haven Az LLC | Community Based Residential Treatment Facility, Mental Illness | 1110 W Hadley St, Phoenix, AZ 85007-3610 | 2020-03-16 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| Find all providers in PHOENIX | ||||
Please comment or provide details below to improve the information on THE HERITAGE BEHAVIORAL HEALTH HOME LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.