TRI-PHASE GROUP HOME INC (NPI# 1578736039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578736039 |
| Entity Type | Organization |
| Organization Name | TRI-PHASE GROUP HOME INC |
| Practice Address |
111 S Lazona Dr Mesa AZ 85204-1222 |
| Mailing Address |
18403 W Verdin Rd Goodyear AZ 85338-5081 |
| Practice Telephone | 6234746326 |
| Practice Fax Number | 6234746516 |
| Mailing Telephone | 6234746326 |
| Mailing Fax Number | 6234746516 |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | MRS. SHERRI MCKINNEY (OWNER/DIRECTOR) |
| Authorized Official Telephone | 6234746326 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
BH-3081 | AZ | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396914735 | Tri-phase Group Home Inc | Substance Abuse Rehabilitation Facility | 1575 E Betsy Ln Unit D, Gilbert, AZ 85296-3759 | 2008-02-28 |
| Street Address |
111 S LAZONA DR |
| City | MESA |
| State | AZ |
| Zip Code | 85204-1222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043483704 | Tri-phase Group Inc | Substance Abuse Rehabilitation Facility | 2355 E Elmwood St, Mesa, AZ 85213-5909 | 2008-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518417583 | Life Change Family Services Inc | Substance Abuse Rehabilitation Facility | 20018 N Toledo Ave, Maricopa, AZ 85138-5359 | 2016-10-13 |
| 1437401536 | The Haven | Substance Abuse Rehabilitation Facility | 1015 E Adelaide Dr, Tucson, AZ 85719-2605 | 2012-10-12 |
| 1033497276 | Arivaca Ranch LLC | Substance Abuse Rehabilitation Facility | 38000 South Arivaca Ranch Road, Arivaca, AZ 85601 | 2011-07-21 |
| 1275861007 | Mhcti LLC | Substance Abuse Rehabilitation Facility | 3771 E Brooks Farms Rd, Gilbert, AZ 85298-5811 | 2009-12-07 |
| 1679800106 | Westcare Arizona I, Inc. | Substance Abuse Rehabilitation Facility | 1800 Rio Vista Dr, Bullhead City, AZ 86442-7229 | 2009-11-04 |
| 1396914735 | Tri-phase Group Home Inc | Substance Abuse Rehabilitation Facility | 1575 E Betsy Ln Unit D, Gilbert, AZ 85296-3759 | 2008-02-28 |
| 1487862959 | Navajo Nation Department of Behavioral Health Services | Substance Abuse Rehabilitation Facility | Navajo Route 7, Duplex 2003, Chinle, AZ 86503-0777 | 2007-05-18 |
| 1780809376 | American Indian Prevention Coalition | Substance Abuse Rehabilitation Facility | 1902 N 23rd St, Phoenix, AZ 85006-2428 | 2007-04-17 |
| 1114141918 | American Indian Prevention Coalition | Substance Abuse Rehabilitation Facility | 1622 N 27th Pl, Phoenix, AZ 85008-3610 | 2007-04-12 |
| 1356565105 | American Indian Prevention Coalition | Substance Abuse Rehabilitation Facility | 4197 E Shelton Rd, Willcox, AZ 85643-4806 | 2007-04-12 |
| Find all providers with the same taxonomy | ||||
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| 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.