FOREVER PLACE LLC (NPI# 1356948954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356948954 |
Entity Type | Organization |
Organization Name | FOREVER PLACE LLC |
Practice Address |
4200 N Pebble Creek Pkwy Apt 2069 Goodyear AZ 85395-9028 |
Practice Telephone | 5672254008 |
Mailing Telephone | 5672254008 |
Enumeration Date | 2020-10-06 |
Last Update Date | 2020-10-06 |
Authorized Official Name | MS. LACHONIQUIE EVANS (OWNER/DIRECTOR) |
Authorized Official Telephone | 5672254008 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
4200 N PEBBLE CREEK PKWY APT 2069 |
City | GOODYEAR |
State | AZ |
Zip Code | 85395-9028 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154962439 | Amber Dawn Gutierrez | Registered Nurse | 15430 W. Turney Avenue, Goodyear, AZ 85395 | 2019-10-08 |
1851947865 | Az Care Partners Home Care, LLC | Chore Provider | 14122 W. Mcdowell Rd., Suite 102a, Goodyear, AZ 85395 | 2019-08-15 |
1407334329 | Hana M Eichele | Occupational Therapist | 13385 W Mcdowell Road, Goodyear, AZ 85395 | 2018-08-02 |
1639662406 | Kristen Henderson | Occupational Therapist | 14577 W Indian School Road, Goodyear, AZ 85395 | 2018-06-07 |
1114419389 | Eric Seabaugh | Specialist/Technologist | 13385 W. Mcdowell Rd., Goodyear, AZ 85395 | 2018-06-04 |
1912497504 | Goodyear Modern Dentistry, LLP | Dentist | 15260 West Mcdowell Rd, Goodyear, AZ 85395 | 2018-05-18 |
1225531551 | Erik Jason Martinez | Registered Nurse | 4565 N 153rd Ln, Goodyear, AZ 85395 | 2018-03-13 |
1538677042 | Kacie Bartlett | Speech-Language Pathologist | 14557 W Mcdowel Rd, Suiet 500, Goodyear, AZ 85395 | 2018-01-18 |
1942717277 | Deeann Guymon | Specialist/Technologist | 13385 W. Mcdowell Road, Goodyear, AZ 85395 | 2018-01-09 |
1023520228 | Kathy Lynn Gorchesky | Registered Nurse | 15430 West Turney Avenue, Goodyear, AZ 85395 | 2017-10-27 |
Find all providers in zip 85395 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972141422 | Av Care Agency LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2267 S 173rd Dr, Goodyear, AZ 85338-1961 | 2019-12-16 |
1659719995 | Arizona Behavioral Care Homes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 560 N 159th Ln, Goodyear, AZ 85338-3276 | 2013-06-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285245407 | Ams Living, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3058 E Nance St, Mesa, AZ 85213-1644 | 2020-08-11 |
1437768892 | Max Care Center LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2239 W Hasan Dr, Phoenix, AZ 85041-5312 | 2020-07-30 |
1265050876 | Arizona Alternative Support, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36379 W El Greco St, Maricopa, AZ 85138-5323 | 2020-07-09 |
1255957304 | Benchmark Valley LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7209 W Forest Grove Ave, Phoenix, AZ 85043-7303 | 2020-06-24 |
1265067052 | Benchmark Valley LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7321 S 15th Dr, Phoenix, AZ 85041-6932 | 2020-03-12 |
1083249874 | Benchmark Valley LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1506 E Irwin Ave, Phoenix, AZ 85042-5618 | 2020-03-12 |
1861024069 | New Roots Residency LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3139 W Carson Rd, Phoenix, AZ 85041-6342 | 2020-02-06 |
1972149078 | Serenitybehavioralhealth.llc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15202 N Flamenco Dr, Phoenix, AZ 85053-4872 | 2019-11-23 |
1952945370 | Natalie Miranda Contreras | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5717 S Southland Blvd Apt D, Tucson, AZ 85706-4241 | 2019-10-29 |
1386102788 | Huduma House, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6221 W Illini St, Phoenix, AZ 85043-1915 | 2019-03-05 |
Find all providers with the same taxonomy |
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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.