ANTHONY UDOINWANG (NPI# 1639798143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639798143 |
| Entity Type | Individual |
| Full Name | ANTHONY UDOINWANG |
| Practice Address |
10435 W Reade Ave Glendale AZ 85307-4237 |
| Mailing Address |
Po Box 14392 Phoenix AZ 85063-4392 |
| Practice Telephone | 6235940997 |
| Practice Fax Number | 6235940998 |
| Mailing Telephone | 6027574861 |
| Mailing Fax Number | 6235940998 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
10435 W READE AVE |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85307-4237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154635761 | Aeroptics LLC | Optometrist | 7071 N 138th Av, Bldg 1540, Glendale, AZ 85307 | 2010-08-06 |
| 1902894579 | Daniela Nicosia | Optometrist | 7071 N 138th Ave, Luke Afb, AZ 85307 | 2005-10-07 |
| 1144633157 | Sharan Kaur Knott | Pharmacist | 10945 W Vista Ln, Glendale, AZ 85307-1645 | 2014-06-06 |
| 1841813961 | Yoshica Mitchell | Behavior Technician | 12923 W Lawrence Ct, Glendale, AZ 85307-1900 | 2020-05-22 |
| 1700328556 | Tonya Brown | Social Worker | 12912 W Mclellan Rd, Glendale, AZ 85307-1917 | 2016-11-10 |
| 1447806997 | Tamarra Kalamchi | Dentist | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-08-12 |
| 1043623648 | Dr Larsen Eye Care Inc | Optometrist | 7071 N 138th Ave # 1552, Luke Afb, AZ 85307-2006 | 2014-06-11 |
| 1619519840 | Platinum Venture Group LLC | Durable Medical Equipment & Medical Supplies | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-10-09 |
| 1710255989 | Optical Center | Technician/Technologist | 7071 N 138th Ave, Glendale, AZ 85307-2006 | 2011-12-02 |
| 1386088128 | Clifton Jamar Premo | Respiratory Therapist, Registered | 13517 W Glendale Ave, Apt 1135, Glendale, AZ 85307-2010 | 2013-04-23 |
| Find all providers in zip 85307 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255504445 | Back To Life, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 20011 N 77th Ave, Glendale, AZ 85308-8337 | 2008-04-08 |
| 1710374442 | Looking Forward Behavioral Health Residential Facility Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 6202 W Oregon Ave, Glendale, AZ 85301-6632 | 2015-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666039 | Rehoboth LLC | Residential Treatment Facility, Emotionally Disturbed Children | 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 | 2020-10-16 |
| 1962022665 | New Hope of Arizona, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8710 W Watkins St, Tolleson, AZ 85353-9028 | 2020-04-22 |
| 1033756358 | Native Music Coalition | Residential Treatment Facility, Emotionally Disturbed Children | 5150 S Crazy Cat Ln, Tucson, AZ 85735 | 2019-12-05 |
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1487118865 | Serenity Preferred LLC | Residential Treatment Facility, Emotionally Disturbed Children | 17829 W Columbine Dr, Surprise, AZ 85388-5628 | 2019-01-30 |
| 1407333958 | Copa's Caring Hands LLC. | Residential Treatment Facility, Emotionally Disturbed Children | 42251 W Bravo Dr, Maricopa, AZ 85138-2295 | 2018-07-26 |
| 1538668983 | Starks Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7325 E Fayette St, Tucson, AZ 85730-2324 | 2018-02-12 |
| 1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
| 1033625926 | Youth Transition Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1190 S Boulder St Unit D, Gilbert, AZ 85296-3792 | 2017-12-14 |
| 1538681374 | Rey Ash Residential Facility LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3765 W Yellow Peak Dr, San Tan Valley, AZ 85142-3090 | 2017-07-13 |
| 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.