PHOENIX VAMC (NPI# 1104286418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104286418 |
| Entity Type | Organization |
| Organization Name | PHOENIX VAMC |
| Other Organization Name | PHOENIX VA CARE SITE |
| Practice Address |
650 E Indian School Rd Phoenix AZ 85012-1839 |
| Mailing Address |
Po Box 94413 Cleveland OH 44101-4413 |
| Practice Telephone | 7023413152 |
| Mailing Telephone | 7023413152 |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2017-11-01 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| PHOENIX VA CARE SITE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619352077 | Phoenix Vamc | Clinic/Center | 1500 East Thomas Road, Suite 106, Phoenix, AZ 85014-5748 | 2015-07-28 |
| 1265785364 | Phoenix Vamc | Clinic/Center | 11390 East Via Linda Road, Suite 105, Scottsdale, AZ 85259-4075 | 2012-10-26 |
| 1033345624 | Phoenix Vamc | Clinic/Center | 9424 N 25th Ave, Phoenix, AZ 85021-2714 | 2009-06-09 |
| 1437197902 | Phoenix Vamc | Clinic/Center | 3285 S Val Vista Dr, Gilbert, AZ 85297-7000 | 2006-06-04 |
| 1215974696 | Phoenix Vamc | Clinic/Center | 903 E Highway 260, Suite 2, Payson, AZ 85531-4972 | 2006-06-02 |
| 1205874351 | Phoenix Vamc | Clinic/Center | 2450 E Show Low Lake Rd, Suite 1, Show Low, AZ 85901-7953 | 2006-06-02 |
| 1629582184 | Phoenix Vamc | Clinic/Center | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2017-11-20 |
| 1174065791 | Phoenix Vamc | Clinic/Center | 5040 N 15th Ave, Phoenix, AZ 85015-3328 | 2016-11-14 |
| 1053586545 | Phoenix Vamc | Clinic/Center | 5860 S Hospital Dr, Suite 111, Globe, AZ 85501-9449 | 2008-04-25 |
| 1598704512 | Phoenix Vamc | Clinic/Center | 13985 W Grand Ave, Suite 101, Surprise, AZ 85374-3625 | 2006-06-05 |
| Street Address |
650 E INDIAN SCHOOL RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679579213 | Carlos J Carrera | Psychiatry & Neurology | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2005-06-27 |
| 1568063220 | Lucas Alan Bodine | Physical Therapist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-11-07 |
| 1417558206 | Elijah Robles Lazo | Physical Medicine & Rehabilitation | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-11-06 |
| 1871191486 | Samantha Roberts | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-10-15 |
| 1760099667 | Dino Alihodzic | Psychologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-09-25 |
| 1659986768 | Jennica Lynne Failner | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-09-15 |
| 1568074557 | Danielle Marie Mcgraw | Psychologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-08-20 |
| 1841802055 | Courtney Loera | Pharmacist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-08-19 |
| 1659980613 | Nakia Andrea Willis | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-07-27 |
| 1487263430 | Lauren Larue Waznik | Dietitian, Registered | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-07-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
| 1437773942 | Excellent Care LLC | Psychiatric Residential Treatment Facility | 14029 N 39th Ave, Phoenix, AZ 85053-5438 | 2020-06-01 |
| 1235750977 | Sagamar Behavioral Care Home, LLC | Psychiatric Residential Treatment Facility | 4444 N 13th Pl Apt 3, Phoenix, AZ 85014-4584 | 2020-05-05 |
| 1114552122 | Angel Heart Behavioral Health IIi LLC | Psychiatric Residential Treatment Facility | 9223 W Meadow Brook, 9223 W Meadow Brook Ave, Phoenix, AZ 85037-8503 | 2020-03-10 |
| 1376178707 | Angel Heart Behavioral Health II LLC | Psychiatric Residential Treatment Facility | 9223 W Meadowbrook Ave, Phoenix, AZ 85037-2442 | 2020-03-05 |
| 1942848627 | Live Well Assisted Living | Psychiatric Residential Treatment Facility | 4544 N 91st Dr, Phoenix, AZ 85037-2449 | 2019-12-13 |
| 1780245506 | A-making Changes | Psychiatric Residential Treatment Facility | 1010 W Euclid Ave, Phoenix, AZ 85041-8345 | 2019-06-24 |
| 1356807549 | Ashante Washington | Psychiatric Residential Treatment Facility | 1438 E Polk St, Phoenix, AZ 85006-3687 | 2019-02-13 |
| 1154703320 | Jfm Inspirations LLC | Psychiatric Residential Treatment Facility | 1121 N 24th Pl, Phoenix, AZ 85008-4910 | 2015-06-24 |
| 1285060111 | Jfm Inspirations Counseling Services | Psychiatric Residential Treatment Facility | 2427 N 71st Ave, Phoenix, AZ 85035-2611 | 2013-09-24 |
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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.