MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME 2 (NPI# 1396253514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396253514 |
| Entity Type | Organization |
| Organization Name | MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME 2 |
| Practice Address |
9010 N 63rd Dr Glendale AZ 85302-4031 |
| Practice Telephone | 6233285688 |
| Practice Fax Number | 6233285688 |
| Mailing Telephone | 6233285688 |
| Mailing Fax Number | 6233285688 |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |
| Authorized Official Name | MR. DEOGRATIAS BARANSAKA (ADMINISTRATOR) |
| Authorized Official Telephone | 6237608378 |
| Is Organization Subpart | Y |
| Parent Organization Name | MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | BH5344 | AZ | Agencies |
| Street Address |
9010 N 63RD DR |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85302-4031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736190 | Tyler Davis LLC | Psychologist | 8607 N 59th Ave Suite C-6, Glendale, AZ 85302 | 2020-10-05 |
| 1679098420 | Sidney M Kingery | Physical Therapist | 5810 W Peoria Ave, Glendale, AZ 85302 | 2017-08-12 |
| 1255877825 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 5651 W. Harmont Dr, Glendale, AZ 85302 | 2017-01-06 |
| 1346696382 | Megan Mari Byrne | Chiropractor | 8425 N 61st Dr., Glendale, AZ 85302 | 2016-05-09 |
| 1558742007 | Farzan Mojgani | Dentist | 5929 W. Peoria Ave. Suite 101, Glendale, AZ 85302 | 2015-06-10 |
| 1255757308 | Glendale Modern Dentistry, LLP | Dentist | 5143 West Olive Ave, Suite 140, Glendale, AZ 85302 | 2014-03-13 |
| 1518391341 | Crystal Nicole-marie Whitman | Physical Therapy Assistant | 5411 W. Cinnabar Ave., Glendale, AZ 85302 | 2013-08-28 |
| 1013349570 | A New Leaf | Clinic/Center | 8581 N 61st Ave, Building A, Suite 101-102, Glendale, AZ 85302 | 2013-08-06 |
| 1255602439 | Alicia S Fennemore | Specialist/Technologist | 352 E. Camelback Rd., Suite 102, Phoenix, AZ 85302 | 2012-01-20 |
| 1639306731 | Total Medical Care, LLC | Clinic/Center | 5048 W. Northern Avenue, Suite 105, Glendale, AZ 85302 | 2009-06-16 |
| Find all providers in zip 85302 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602889 | Plsn Corp. | Community/Behavioral Health | 8751 N 51st Ave Ste 108, Glendale, AZ 85302-4943 | 2020-09-06 |
| 1861010340 | Redfield Behavioral Health LLC | Community/Behavioral Health | 4842 W Redfield Rd, Glendale, AZ 85306-4910 | 2020-07-10 |
| 1649895129 | Freedom Family Counseling, LLC | Community/Behavioral Health | 17250 N 43rd Ave Ste 4, Glendale, AZ 85308-4032 | 2020-06-10 |
| 1407482268 | Loloma Houses LLC | Community/Behavioral Health | 6125 W Sunnyside Dr, Glendale, AZ 85304-2533 | 2020-03-12 |
| 1922644897 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 12009 N 45th Dr, Glendale, AZ 85304-3010 | 2019-11-26 |
| 1942841770 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 10120 W Oregon Ave, Glendale, AZ 85307-4149 | 2019-10-02 |
| 1417420142 | Family Involvement Center, Inc | Community/Behavioral Health | 5044 W Cactus Rd, Glendale, AZ 85304-2243 | 2019-01-04 |
| 1740776640 | Anka Behavioral Health Incorporated | Community/Behavioral Health | 1014 Zook Dr, Glendale, CA 91202-2623 | 2018-07-03 |
| 1629581988 | Tangeroad, LLC | Community/Behavioral Health | 229 N Central Ave Ste 402, Glendale, CA 91203-3542 | 2017-11-08 |
| 1881125219 | Caring for Arizona, Inc | Community/Behavioral Health | 6802 N 47th Ave Ste 5, Glendale, AZ 85301-3599 | 2017-03-27 |
| Find all providers in GLENDALE | ||||
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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.