SEMPER FIDELIS BEHAVIORAL HEALTH CARE, LLC (NPI# 1265057962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265057962 |
| Entity Type | Organization |
| Organization Name | SEMPER FIDELIS BEHAVIORAL HEALTH CARE, LLC |
| Practice Address |
111 N Dupont Cir Unit 337 Phoenix AZ 85034-1847 |
| Practice Telephone | 8603083823 |
| Mailing Telephone | 8603083823 |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | NASSON NATHAN (ADMINISTRATOR) |
| Authorized Official Telephone | 4804305491 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891312542 | Semper Fidelis Behavioral Health Care, LLC | Substance Abuse Rehabilitation Facility | 8020 N 17th Dr, Phoenix, AZ 85021-5217 | 2020-06-29 |
| Street Address |
111 N DUPONT CIR UNIT 337 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85034-1847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093208340 | Curtis James Bierscheid | Physical Therapist | 1828 E Sky Harbor Circle North, Building 2, Suite 150, Phoenix, AZ 85034 | 2018-06-12 |
| 1437654969 | Genoa Healthcare, LLC | Pharmacy | 1035 E Jefferson St Ste P1, Phoenix, AZ 85034 | 2018-03-27 |
| 1659871697 | Us Careways-phx | Clinic/Center | 3800 E Sky Harbor Blvd, Phoenix, AZ 85034 | 2018-02-16 |
| 1053854638 | Josiah Nnadozie Nwaokwa | Nurse Practitioner | 1035 E Jefferson Street, La Frontera -empact Spc, Phoenix, AZ 85034 | 2016-11-30 |
| 1568869915 | Lacee Johnson | Speech-Language Pathologist | 5025 E Washington Street, Suite 212, Phoenix, AZ 85034 | 2014-12-01 |
| 1679974406 | Jagdeep Bains | Pharmacist | 5324 E Washington St, #a, Phoenix, AZ 85034 | 2014-09-11 |
| 1275885030 | Nancy Louise Brewer | Nurse Practitioner | 3800 E Sky Harbor Blvd Fl T4, Phoenix, AZ 85034 | 2012-10-03 |
| 1386928414 | The Facts of Life Grouphome, Inc | Community/Behavioral Health | 1122 E. Buckeye Road, Phoenix, AZ 85034 | 2011-10-07 |
| 1649559832 | Us Medgroup Pa | Clinic/Center | 901 East Jefferson St, Phoenix, AZ 85034 | 2011-08-05 |
| 1689979106 | Latanya King | Counselor | 1122 East Buckeye Road, Suite B-1, Phoenix, AZ 85034 | 2011-01-13 |
| Find all providers in zip 85034 | ||||
| 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 |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1043846561 | Happy Haven Az LLC | Community Based Residential Treatment Facility, Mental Illness | 1110 W Hadley St, Phoenix, AZ 85007-3610 | 2020-03-16 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| 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.