SONORAN SKY COMMUNITY SERVICES, INC. (NPI# 1174041883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174041883 |
| Entity Type | Organization |
| Organization Name | SONORAN SKY COMMUNITY SERVICES, INC. |
| Practice Address |
4226 W Marco Polo Rd Glendale AZ 85308-2285 |
| Mailing Address |
9601 N Black Canyon Hwy Phoenix AZ 85021-2702 |
| Practice Telephone | 6238696882 |
| Practice Fax Number | 6026740942 |
| Mailing Telephone | (602) 216-0518 |
| Mailing Fax Number | 6026740942 |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MRS. SUSAN CAROL JORDE (DIRECTOR) |
| Authorized Official Telephone | 6022160518 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH5177 | AZ | Residential Treatment Facilities |
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH5176 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | COMMUNITY BASED RESIDENTIAL TREATMENT FACILITY, MENTAL ILLNESS | 769554 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115255 | Sonoran Sky Community Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 9601 N Black Canyon Hwy, Phoenix, AZ 85021-2702 | 2020-02-12 |
| 1629581913 | Sonoran Sky Community Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1745 W Lawrence Ln, Phoenix, AZ 85021-4335 | 2017-11-09 |
| 1821291345 | Sonoran Sky Community Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9033 N 24th Ave Ste 8, Phoenix, AZ 85021-2847 | 2007-06-11 |
| 1538226485 | Sonoran Sky Community Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9033 N 24th Ave, 8, Phoenix, AZ 85021-2847 | 2007-01-02 |
| 1538669684 | Sonoran Sky Community Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 417 E Tierra Buena Ln, Phoenix, AZ 85022-3034 | 2018-02-15 |
| 1952810335 | Sonoran Sky Community Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5710 W Orchid Ln, Glendale, AZ 85302-4654 | 2017-09-28 |
| Street Address |
4226 W MARCO POLO RD |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85308-2285 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124579578 | Sonoran Sky Community Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4226 W Marco Polo Rd, Glendale, AZ 85308-2285 | 2016-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
| 1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
| 1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
| 1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
| 1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
| 1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
| 1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
| 1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
| Find all providers in zip 85308 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505054 | Joy Recovery and Behavioral Health, LLC | Community Based Residential Treatment Facility, Mental Illness | 24212 N 42nd Dr, Glendale, AZ 85310-3232 | 2020-03-31 |
| 1275163214 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 17219 N Lindner Dr, Glendale, AZ 85308-3308 | 2020-01-17 |
| 1730607300 | Sonoran Sky Community, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5710 W Orchid Ln, Glendale, AZ 85302-4654 | 2017-09-05 |
| 1861932097 | Ska-shifra Facility | Community Based Residential Treatment Facility, Mental Illness | 7136 N 73rd Dr, Glendale, AZ 85303-2569 | 2017-03-07 |
| 1528504826 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 4214 W Behrend Dr, Glendale, AZ 85308-2284 | 2017-01-10 |
| 1134665680 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 4912 W Echo Ln, Glendale, AZ 85302-6315 | 2017-01-09 |
| 1588100036 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 8028 N 56th Ln, Glendale, AZ 85302-4661 | 2017-01-09 |
| 1679019129 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 19808 N 42nd Ave, Glendale, AZ 85308-2291 | 2017-01-09 |
| 1710423389 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 3912 W Potter Dr, Glendale, AZ 85308-4605 | 2017-01-06 |
| 1366988933 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 5148 W. Frier Dr, Glendale, AZ 85301 | 2017-01-06 |
| Find all providers in GLENDALE | ||||
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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.