HUDUMA HOUSE, LLC (NPI# 1386102788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386102788 |
Entity Type | Organization |
Organization Name | HUDUMA HOUSE, LLC |
Practice Address |
6221 W Illini St Phoenix AZ 85043-1915 |
Practice Telephone | 6025169785 |
Mailing Telephone | 6025169785 |
Enumeration Date | 2019-03-05 |
Last Update Date | 2019-03-05 |
Authorized Official Name | MR. ROBERT K KOSKEI (HEALTHCARE MANAGER) |
Authorized Official Telephone | 6025169785 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | ARIZONA DEPARTMENT OF HEALTH SERVICES | BH5656 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851909964 | Huduma House, LLC | Assisted Living Facility | 6218 W Raymond St, Phoenix, AZ 85043 | 2020-07-15 |
Street Address |
6221 W ILLINI ST |
City | PHOENIX |
State | AZ |
Zip Code | 85043-1915 |
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 |
1962936112 | Christine B Santa Cruz | Specialist/Technologist | 8101 W. Hammond Ln., Phoenix, AZ 85043 | 2017-04-14 |
1558704809 | Valley Independent Residential LLC | Community Based Residential Treatment Facility, Mental Illness | 6408 W Gross Ave, Phoenix, AZ 85043 | 2013-04-16 |
1275811598 | Diamond Manor Adult Care | Custodial Care Facility | 7330 W. Getty Drive, Phoenix, AZ 85043 | 2011-08-03 |
1821312877 | Bertha Romero | Case Manager/Care Coordinator | 7315 W Jones Ave, Phx, AZ 85043 | 2010-03-19 |
1477705788 | Patrick Lynn Perryman | Psychologist | 7250 W Buckeye Rd, Phoenix, AZ 85043 | 2008-10-17 |
1891910246 | Sammie Trotter | Technician | 5025 S. 24th Ave, Phoenix, AZ 85043 | 2007-04-13 |
1780719617 | German Dobson Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 6650 W. Lower Buckeye Rd, Phoenix, AZ 85043 | 2007-02-22 |
1992713689 | Occupational Health Center of The Southwest Pa | Clinic/Center | 5340 West Buckeye Road, Suite 3, Phoenix, AZ 85043 | 2006-08-04 |
1972523710 | William A Crane Jr. | Family Medicine | 7953 W Chickasaw St, Phoenix, AZ 85043 | 2006-07-21 |
Find all providers in zip 85043 |
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 |
---|---|---|---|---|
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 |
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 |
1396158481 | Every Voice Counts | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10610 S 48th St, Unit 1068, Phoenix, AZ 85044-1743 | 2014-06-05 |
1902131865 | Master Care, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 28809 N 25th Gln, Phoenix, AZ 85085-3737 | 2009-10-11 |
1811167067 | Arizona Health Care Contract Management Services Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2208 W Keim Dr, Phoenix, AZ 85015-1943 | 2008-03-04 |
1407026644 | Arizona Health Care Contract Management Services Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5344 N 40th Ln, Phoenix, AZ 85019-2213 | 2008-03-04 |
Find all providers in PHOENIX |
Please comment or provide details below to improve the information on HUDUMA HOUSE, LLC.
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.