HOLY TRINITY BEHAVIORAL,LLC (NPI# 1104381300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104381300 |
| Entity Type | Organization |
| Organization Name | HOLY TRINITY BEHAVIORAL,LLC |
| Practice Address |
5208 W Avalon Dr Phoenix AZ 85031-3958 |
| Practice Telephone | 6232719011 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |
| Authorized Official Name | CHRISTINE KEMBOI (DIRECTOR) |
| Authorized Official Telephone | 6232719011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420476 | Holy Trinity Behavioral,llc | Assisted Living Facility | 1630 W Nancy Ln, Phoenix, AZ 85041-5540 | 2020-02-23 |
| 1184258758 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5308 W Vernon Ave, Phoenix, AZ 85035-1953 | 2020-02-23 |
| Street Address |
5208 W AVALON DR |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85031-3958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184244634 | Dale Keith Cooper | Behavioral Analyst | 5208 W Avalon Dr, Phoenix, AZ 85031-3958 | 2020-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508256629 | Jessica Watson | Physical Therapy Assistant | 4110 N 108th Ave, Suite 103, Phoenix, AZ 85031 | 2015-01-27 |
| 1043518707 | Lisette V Hill | Nurse Practitioner | 3802 N 53rd Avenue, Suite 160, Phoenix, AZ 85031 | 2011-03-04 |
| 1760785778 | Unlimited Smiles | Dentist | 4805 West Thomas, Suite #a, Phoenix, AZ 85031 | 2010-12-13 |
| 1043526817 | Atul J Amin | Pharmacist | 5102 W Indian School Rd (walgreens), Phoenix, AZ 85031 | 2010-08-31 |
| 1396064663 | Akdhc, LLC | Internal Medicine | 4524 N Maryvale Parkway, Akdhc, LLC - Maryvale, Ste 160, Phoenix, AZ 85031 | 2010-05-25 |
| 1629397583 | Scott Anthony Effinger | Pharmacist | 4616 N. 51st Avenue, Suite 203, Phoenix, AZ 85031 | 2010-05-18 |
| 1912237397 | Albert Potter | Counselor | 5043 W. Campbell Ave., Phoenix, AZ 85031 | 2010-01-06 |
| 1649434887 | Mahmoud Azmi Mahafzah | Internal Medicine | 5251 W Campbell Ave Ste 204, Phoenix, AZ 85031 | 2008-07-16 |
| 1427253335 | Evelyn Tan Omana-roldan | Family Medicine | 4700 N. 51st Avenue, Suite 1, Phoenix, AZ 85031 | 2007-06-19 |
| 1255416103 | Chicanos Por La Causa Inc | Clinic/Center | 4602 W. Indian School Rd., Cplc Centro De La Familia, Phoenix, AZ 85031 | 2006-10-26 |
| Find all providers in zip 85031 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536752 | The Heritage Behavioral Health Home LLC | Assisted Living Facility | 3927 W Rovey Ave, Phoenix, AZ 85019-1633 | 2020-07-29 |
| 1801420476 | Holy Trinity Behavioral,llc | Assisted Living Facility | 1630 W Nancy Ln, Phoenix, AZ 85041-5540 | 2020-02-23 |
| 1184258758 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5308 W Vernon Ave, Phoenix, AZ 85035-1953 | 2020-02-23 |
| 1083261945 | D&g Behavioral Health LLC | Assisted Living Facility | 3119 N 46th Dr, Phoenix, AZ 85031-3705 | 2019-08-24 |
| 1881249902 | A Tender Hand Assisted Living Home, LLC, Dba | Assisted Living Facility | 6216 S 36th St, Phoenix, AZ 85042-4904 | 2019-08-06 |
| 1265098339 | Affinity of Hope Care Home | Assisted Living Facility | 7518 S 15th Dr, Phoenix, AZ 85041-6935 | 2019-05-14 |
| 1538625744 | N & T Behavioral Health LLC | Assisted Living Facility | 6150 W Cheery Lynn Rd, Phoenix, AZ 85033-5833 | 2019-02-12 |
| 1225592025 | Royal Behavioral Health LLC | Assisted Living Facility | 3845 W Mauna Loa Ln, Phoenix, AZ 85053-4538 | 2019-01-25 |
| 1629580717 | Brenton Casteel | Assisted Living Facility | 4638 E Summerhaven Dr, Phoenix, AZ 85044-4820 | 2017-10-29 |
| 1275042657 | Prestige Group Homes | Assisted Living Facility | 28001 N 31st Ave, Phoenix, AZ 85083 | 2017-09-28 |
| Find all providers in PHOENIX | ||||
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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.