AMANDA ELLIS (NPI# 1194198697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194198697 |
| Entity Type | Individual |
| Full Name | AMANDA ELLIS |
| Practice Address |
381 East Brook Street San Tan Valley AZ 85140 |
| Mailing Address |
381 E Brook St San Tan Valley AZ 85140 |
| Practice Telephone | 4804952839 |
| Mailing Telephone | 4804952839 |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | D05686544 | AZ | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902443195 | Amanda L Ellis | Family Medicine | 750 Albemarle Ave, Cuyahoga Falls, OH 44221-4814 | 2019-12-06 |
| 1386138907 | Amanda Frances Ellis | Dietitian, Registered | 915 118th Ave Se, Attention Alecia Johnson, Ret Physica, Suite 110, Bellevue, WA 98005 | 2018-06-18 |
| 1558876748 | Amanda Ellis | Behavior Technician | 2751 Legends Pkwy Ste 2, Prattville, AL 36066-7754 | 2017-12-10 |
| 1568070654 | Amanda D Ellis | Nurse Practitioner | 3841 Piper St Ste T100, Anchorage, AK 99508-4674 | 2020-07-15 |
| 1336795327 | Amanda Nicole Ellis | Counselor | 128 N 2nd St Ste 202, Clarksville, TN 37040-6460 | 2019-08-15 |
| 1316508930 | Amanda Ellis | Behavior Technician | 300 Saint Andrews Rd Ste 408, Saginaw, MI 48638 | 2019-06-25 |
| 1972164689 | Amanda Elizabeth Ellis | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2019-06-24 |
| 1649836024 | Amanda Ellis | Dentist | 1001 Covington St, Youngstown, OH 44510-1617 | 2019-05-12 |
| 1780145029 | Amanda Ellis | Counselor | 21545 Centre Pointe Pkwy, Santa Clarita, CA 91350-2947 | 2019-03-28 |
| 1760955058 | Amanda Ellis | Behavioral Analyst | 6 Strathmore Rd, Natick, MA 01760-2419 | 2019-01-09 |
| Street Address |
381 EAST BROOK STREET |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801429634 | Bhsm Rehabilitation, LLC | Clinic/Center | 37200 North Gantzel Road, Suite 260, Queen Creek, AZ 85140 | 2020-02-20 |
| 1801455712 | Jose Enrique Knox | Specialist/Technologist, Other | 36018 North Secret Garden Path, Queen Creek, AZ 85140 | 2019-06-13 |
| 1629546171 | San Tan Valley Oral Facial and Implant Surgery Pllc | Oral & Maxillofacial Surgery | 36327 N Gantzel Rd, Suite 102, San Tan Valley, AZ 85140 | 2018-11-02 |
| 1780164582 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 40950 N Ironwood Dr, Queen Creek, AZ 85140 | 2018-08-21 |
| 1497249452 | San Tan Primary Care PC | Family Medicine | 36283 N Gantzel Rd Ste 101, San Tan Valley, AZ 85140 | 2018-06-21 |
| 1306386115 | Veronica Gonzalez | Licensed Practical Nurse | 733 E Angeline Ave, Queen Creek, AZ 85140 | 2017-02-27 |
| 1043688336 | Felicia D Adams | Day Training/Habilitation Specialist | 1074 E. Press Rd, San Tan Valley, AZ 85140 | 2015-09-03 |
| 1376928598 | Amy Burks | Physical Therapy Assistant | 1479 E Oak Rd, San Tan Valley, AZ 85140 | 2015-07-29 |
| 1316367121 | Shanaya Suchak | Internal Medicine | 37000 N Gantzel Road, Attn: Hospitalists, San Tan Valley, AZ 85140 | 2014-04-19 |
| 1407296023 | Devin G Anderson | Audiologist | 36305 N Gantzel Rd Ste 104, San Tan Valley, AZ 85140 | 2013-06-27 |
| Find all providers in zip 85140 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656651 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 6858 S 19th St, Phoenix, AZ 85042-5770 | 2020-10-10 |
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1497385892 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 4451 W St Anne Ave, Laveen, AZ 85339-6232 | 2020-01-24 |
| 1023658127 | Carefree Manor Assisted Living LLC | Residential Treatment Facility, Physical Disabilities | 7886 E Breathless Dr, Carefree, AZ 85377 | 2020-01-07 |
| 1497234710 | Sampaguita D. Maglalang | Residential Treatment Facility, Physical Disabilities | My Home Care Adult Assisted Living Facility, LLC., 2607 West Curry Street, Chandler, AZ 85224-1040 | 2018-08-08 |
| 1326533407 | Neuro Rehabcare Scottsdale - Az LLC | Residential Treatment Facility, Physical Disabilities | 7480 E Camino Santo, Scottsdale, AZ 85260-3905 | 2018-06-29 |
| 1356853915 | Pastalino Manor 4 | Residential Treatment Facility, Physical Disabilities | 1421 E Maldonado Dr, Phoenix, AZ 85042-5602 | 2017-11-03 |
| 1770009219 | Neuro Rehabcare of The Valley - Az LLC | Residential Treatment Facility, Physical Disabilities | 8307 W Misty Willow Ln, Peoria, AZ 85383-1511 | 2017-08-16 |
| 1184150484 | Ndg Adult Care Home LLC | Residential Treatment Facility, Physical Disabilities | 1106 W 9th St, Tempe, AZ 85281-5304 | 2017-05-04 |
| 1447658943 | Moses Behavioral Care | Residential Treatment Facility, Physical Disabilities | 17622 W Port Royale Ln, Surprise, AZ 85388-7792 | 2014-12-15 |
| Find all providers with the same taxonomy | ||||
| City | SAN TAN VALLEY |
| Zip Code | 85140 |
Please comment or provide details below to improve the information on AMANDA ELLIS.
| 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.