FLORENCE CRITTENTON SERVICES OF ARIZONA, INC.


Address: 715 W Mariposa St, Phoenix, AZ 85013-2449
Phone: 6022747318

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).

Provider Overview

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.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children BH-2133 AZ Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ 747058 05

Other Provider/Organization Names

Other Name Type Code
FCS Therapeutic Group Home Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 715 W MARIPOSA ST
City PHOENIX
State AZ
Zip Code 85013-2449

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City PHOENIX
Zip Code 85013

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Dataset Information

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.

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