SAN JUDAS GROUP HOME (NPI# 1386969947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386969947 |
| Entity Type | Organization |
| Organization Name | SAN JUDAS GROUP HOME |
| Practice Address |
5116 S 11th Ave Phoenix AZ 85041-2363 |
| Mailing Address |
5415 S 5th Ave Phoenix AZ 85041-4000 |
| Practice Telephone | 6026435932 |
| Practice Fax Number | 6022816974 |
| Mailing Telephone | 6026435932 |
| Mailing Fax Number | 6022816974 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2010-04-07 |
| Authorized Official Name | IMELDA MELISSA NORIEGA (ADMINISTRATOR) |
| Authorized Official Telephone | 6026435932 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | ALH6076 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 203799 | 05 |
| Street Address |
5116 S 11TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85041-2363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558915843 | Our Home of Unity LLC | Counselor | 6804 S 21st Dr, Phoenix, AZ 85041 | 2019-07-25 |
| 1447816590 | Mbong Jerry Ngwese | Physical Therapist | 2546 West Bloch Rd, Phoenix, AZ 85041 | 2019-05-14 |
| 1588228373 | Arizona Dental Management | Dentist | 3515 West Southern Avenue, Suite #152, Phoenix, AZ 85041 | 2019-04-26 |
| 1447780135 | Mesa Dental Arizona LLC | Dentist | 3320 W Southern Ave #111, Phoenix, AZ 85041 | 2017-06-14 |
| 1932564697 | Job Elliott | Counselor | 4105 W Saint Charles Ave, Phoenix, AZ 85041 | 2015-12-23 |
| 1376914739 | Black Family and Child Services Inc | Community/Behavioral Health | 6811 West 33rd Ave, Phoenix, AZ 85041 | 2015-10-12 |
| 1972900983 | Love Living Life | Assisted Living Facility | 5737 S. 34th Ave, Phoenix, AZ 85041 | 2014-11-20 |
| 1891114641 | Maricopa County Special Health Care District | General Acute Care Hospital | 5650 S 35th Ave, Phoenix, AZ 85041 | 2014-04-09 |
| 1265616213 | Southern Dental | Dentist | 3320 W. Southern Avenue, Suite # 108, Phoenix, AZ 85041 | 2007-12-27 |
| 1518140086 | Arizona Cvs Stores,l.l.c. | Durable Medical Equipment & Medical Supplies | 7550 South 19th Ave, Phoenix, AZ 85041 | 2007-12-07 |
| Find all providers in zip 85041 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656651 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 6858 S 19th St, Phoenix, AZ 85042-5770 | 2020-10-10 |
| 1356853915 | Pastalino Manor 4 | Residential Treatment Facility, Physical Disabilities | 1421 E Maldonado Dr, Phoenix, AZ 85042-5602 | 2017-11-03 |
| 1245494178 | National Mentor Healthcare | Residential Treatment Facility, Physical Disabilities | 15032 N 37th Ave, Phoenix, AZ 85053 | 2008-07-10 |
| 1164629333 | Angel Care Home | Residential Treatment Facility, Physical Disabilities | 2231 N 38th St, Phoenix, AZ 85008-3012 | 2007-06-29 |
| 1033564042 | Arizona Therapy Associates, LLC | Residential Treatment Facility, Physical Disabilities | 18444 N 25th Ave, Suite 420-712, Phoenix, AZ 85023-1261 | 2016-04-27 |
| 1558706515 | One Tree Inc | Residential Treatment Facility, Physical Disabilities | 2423 W Dunlap Ave, Phoenix, AZ 85021-2830 | 2013-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1497385892 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 4451 W St Anne Ave, Laveen, AZ 85339-6232 | 2020-01-24 |
| 1023658127 | Carefree Manor Assisted Living LLC | Residential Treatment Facility, Physical Disabilities | 7886 E Breathless Dr, Carefree, AZ 85377 | 2020-01-07 |
| 1497234710 | Sampaguita D. Maglalang | Residential Treatment Facility, Physical Disabilities | My Home Care Adult Assisted Living Facility, LLC., 2607 West Curry Street, Chandler, AZ 85224-1040 | 2018-08-08 |
| 1326533407 | Neuro Rehabcare Scottsdale - Az LLC | Residential Treatment Facility, Physical Disabilities | 7480 E Camino Santo, Scottsdale, AZ 85260-3905 | 2018-06-29 |
| 1770009219 | Neuro Rehabcare of The Valley - Az LLC | Residential Treatment Facility, Physical Disabilities | 8307 W Misty Willow Ln, Peoria, AZ 85383-1511 | 2017-08-16 |
| 1184150484 | Ndg Adult Care Home LLC | Residential Treatment Facility, Physical Disabilities | 1106 W 9th St, Tempe, AZ 85281-5304 | 2017-05-04 |
| 1194198697 | Amanda Ellis | Residential Treatment Facility, Physical Disabilities | 381 East Brook Street, San Tan Valley, AZ 85140 | 2015-11-05 |
| 1447658943 | Moses Behavioral Care | Residential Treatment Facility, Physical Disabilities | 17622 W Port Royale Ln, Surprise, AZ 85388-7792 | 2014-12-15 |
| 1134529282 | Marhaba Home Care LLC | Residential Treatment Facility, Physical Disabilities | 15244 W Watson Ln, Surprise, AZ 85379-7040 | 2014-08-26 |
| 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.