FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. (NPI# 1326217308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326217308 |
Entity Type | Organization |
Organization Name | FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. |
Other Organization Name | FCS THERAPEUTIC GROUP HOME |
Practice Address |
715 W Mariposa St Phoenix AZ 85013-2449 |
Practice Telephone | 6022747318 |
Practice Fax Number | 6022747549 |
Mailing Telephone | 6022747318 |
Mailing Fax Number | 6022747549 |
Enumeration Date | 2008-02-25 |
Last Update Date | 2014-04-28 |
Authorized Official Name | KELLIE M. WARREN (CEO) |
Authorized Official Telephone | 6022747318 |
Authorized Official Credential | PSY.D. |
Is Organization Subpart | Y |
Parent Organization Name | FLORENCE CRITTENTON SERVICES OF ARIZONA, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | BH-2133 | AZ | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 747058 | 05 |
Other Name | Type Code |
---|---|
FCS Therapeutic Group Home | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154358422 | Florence Crittenton Services of Arizona, Inc. | Community/Behavioral Health | 715 W Mariposa St, Phoenix, AZ 85013-2449 | 2006-06-26 |
Street Address |
715 W MARIPOSA ST |
City | PHOENIX |
State | AZ |
Zip Code | 85013-2449 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154358422 | Florence Crittenton Services of Arizona, Inc. | Community/Behavioral Health | 715 W Mariposa St, Phoenix, AZ 85013-2449 | 2006-06-26 |
1639641467 | Donna Noriega | Social Worker | 715 W Mariposa St, Phoenix, AZ 85013-2449 | 2018-12-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043833700 | Marco Antonio Valdez Espinoza | Student in an Organized Health Care Education/Training Program | 500 W. Thomas Road, Suite 900 A, Phoenix, AZ 85013 | 2020-05-28 |
1518588292 | Santiago Garcia Ortiz | Student in an Organized Health Care Education/Training Program | 350w Thomas Rd St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013 | 2020-05-04 |
1356811970 | Lynne Shaunte Coleman | Nurse Practitioner | 3633 N 3rd Ave 2019, Phoenix, AZ 85013 | 2018-11-26 |
1467949156 | Solterra 3rd Indian School Operations, LLC | Assisted Living Facility | 4000 N 3rd Avenue, Phoenix, AZ 85013 | 2018-04-18 |
1083018345 | Romelda Antonio | Nurse Practitioner | 222 W Thomas Rd Ste 212, Phoenix, AZ 85013 | 2014-10-15 |
1760890131 | Emmitt Michael Thompson | General Practice | 822 West Earll Drive, Phoenix, AZ 85013 | 2014-07-29 |
1902218480 | Sreeja Biswas Roy | Internal Medicine | 350 W Thomas Road, Phoenix, AZ 85013 | 2014-06-02 |
1417381120 | Osama Qasim Agha | Internal Medicine | 350 W. Thomas Road, Suite 900a, Phoenix, AZ 85013 | 2013-08-29 |
1245679604 | Oculist Exceptional Eyewear Pllc | Optometrist | 5043-b N 7th Ave, Phoenix, AZ 85013 | 2013-06-19 |
1760829352 | Gina Wilding | Nurse Practitioner | 500 W Thomas Rd Ste 720, Phoenix, AZ 85013 | 2013-05-23 |
Find all providers in zip 85013 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
1023546819 | Zion Living | Residential Treatment Facility, Emotionally Disturbed Children | 1618 E Wood St, Phoenix, AZ 85040-1360 | 2017-05-24 |
1326400623 | Community Network Fellowship, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1839 N 39th St, Suite A, Phoenix, AZ 85008-3915 | 2016-03-25 |
1972910248 | Empower House LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2413 W Fetlock Trl, Phoenix, AZ 85085-5770 | 2014-07-17 |
1639596927 | Eagles Nest Group Home, Dba | Residential Treatment Facility, Emotionally Disturbed Children | 1802 E Dobbins Rd, Phoenix, AZ 85042-8500 | 2014-03-25 |
1497032668 | Vision Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 2917 W Bowker St, Phoenix, AZ 85041-3477 | 2011-11-15 |
1548544463 | Cdh Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 4017 E La Puente Ave, Phoenix, AZ 85044-1339 | 2011-10-11 |
1760787527 | United Youth and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 33016 N 24th Ln, Phoenix, AZ 85085-6024 | 2011-01-25 |
1740500966 | Oasis Care Living, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6434 S 17th Pl, Phoenix, AZ 85042-4554 | 2010-06-10 |
Find all providers in PHOENIX |
Please comment or provide details below to improve the information on FLORENCE CRITTENTON SERVICES OF ARIZONA, INC..
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.