OPEN HEARTS (NPI# 1265544324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265544324 |
| Entity Type | Organization |
| Organization Name | OPEN HEARTS |
| Other Organization Name | YOUTH EVALUATION & TREATMENT CENTERS |
| Practice Address |
4414 N 19th Ave Phoenix AZ 85015 |
| Practice Telephone | 6022855550 |
| Practice Fax Number | 6022855551 |
| Mailing Telephone | 6022855550 |
| Mailing Fax Number | 6022855551 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-05-29 |
| Authorized Official Name | ARJELIA GOMEZ (PRESIDENT & CEO) |
| Authorized Official Telephone | 6022855550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | BH-1794 | AZ | Behavioral Health & Social Service Providers |
| N | 101Y00000X | Counselor | BH-1794 | AZ | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
BH-1794 | AZ | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
BH-1794 | AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 349127 | 05 |
| Other Name | Type Code |
|---|---|
| Youth Evaluation & Treatment Centers | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508139213 | Open Hearts | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 509 Beasley St, Princeville, NC 27886-5414 | 2012-02-13 |
| 1174932669 | Open Hearts | Counselor | 3280 S Country Club Way, Tempe, AZ 85282-4065 | 2014-08-08 |
| 1366773723 | Open Hearts | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1400 W Mount Dr, Rocky Mount, NC 27803-3107 | 2010-01-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | OPEN HEARTS | 1250 Ne Cochran Dr, Gresham, OR 97030 |
| Washington State Corporations | OPEN HEARTS ADULT FAMILY HOME LLC | 15510 Ne 79th Way, Vancouver, WA 98682-1535 |
| Washington State Corporations | OPEN HEARTS BIG DREAMS FUND | 3518 241st Ave Se, Sammamish, WA 98029-6317 |
| Washington State Corporations | OPEN HEARTS CLUB MINISTRY | 2566 Joe Austin Dr, Norfolk, VA 23504-3258 |
| Colorado Business Entities | Open Hearts Community Temple | 1571 Beeler St, Apt 310, Aurora, CO 80010 |
| System for Award Management (SAM) Entities | OPEN HEARTS DAYSCHOOL, LLC | 126 W State Highway 152 Ste 1, Mustang, OK 73064-3931 |
| Oklahoma Business Registrations | OPEN HEARTS DAYSCHOOL, LLC | 126 W Hwy 152 Unit #1, Mustang, OK 73064 |
| New York State Corporations | OPEN HEARTS HAITI, INC. | 275 Central Park West, Suite 6a, New York, Ny 10024 |
| Colorado Business Entities | Open Hearts Health Care, LLC | 2620 So. Parker Road, Suite 370, Aurora, CO 80014 |
| New York State Corporations | OPEN HEARTS INITIATIVE, INC. | 1330 Avenue of The Americas, Suite 23a, New York, Ny 10019 |
| Street Address |
4414 N 19TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952924409 | Don Andrew Maryon | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2020-05-19 |
| 1902429418 | Benjamin Pedraza | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2020-05-19 |
| 1922621564 | Lucila Aceves | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2020-05-18 |
| 1427670033 | Ira Roach | Social Worker | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2020-05-18 |
| 1558917278 | Melissa M Cumella | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2019-08-18 |
| 1053778795 | Youth Evaluation and Treatment Centers | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2016-01-26 |
| 1063815520 | Angela Pergola | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2014-09-29 |
| 1265861959 | Randi Janelle Gennaro | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2013-11-04 |
| 1851644074 | Rebecca Ann Duffy | Counselor | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2012-10-25 |
| 1376869289 | Sarah M Hanchett | Social Worker | 4414 N 19th Ave, Phoenix, AZ 85015-4114 | 2010-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922615 | Gift of Hearts Home LLC | Counselor | 4547 N 92nd Ave, Phoenix, AZ 85037-2450 | 2020-11-02 |
| 1952901332 | Jennifer Barreras | Counselor | 1818 E Burgess Ln, Phoenix, AZ 85042-4518 | 2020-10-27 |
| 1477153799 | Haydee Bermudez | Counselor | 3301 North 33rd Ave., Phoenix, AZ 85029 | 2020-10-27 |
| 1174135487 | Kelli Randon | Counselor | 14040 N Cave Creek Rd Ste 207, Phoenix, AZ 85022-6179 | 2020-08-18 |
| 1891307328 | Empire Health and Therapy LLC | Counselor | 1730 W Lacewood Pl, Phoenix, AZ 85045-0528 | 2020-08-17 |
| 1043821747 | Annette M Callahan | Counselor | 3229 E Briarwood Ter, Phoenix, AZ 85048-7843 | 2020-08-14 |
| 1528679032 | Apex Rising Community Services LLC | Counselor | 4150 W Peoria Ave Ste 220, Phoenix, AZ 85029-3956 | 2020-08-10 |
| 1780293654 | Mitsrain's House of Hope LLC | Counselor | 5744 N 41st Ave, Phoenix, AZ 85019-1814 | 2020-07-27 |
| 1740898378 | Samantha Cheyenne-dahl Moss | Counselor | 3519 E Shea Blvd Ste 138, Phoenix, AZ 85028-3349 | 2020-07-20 |
| 1083231856 | Amber Taylor | Counselor | 21640 N 19th Ave, Phoenix, AZ 85027-2720 | 2020-06-28 |
| 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.