GRACE HOUSE BEHAVIORAL HEALTH AGENCY LEVEL 3 (NPI# 1407186737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407186737 |
| Entity Type | Organization |
| Organization Name | GRACE HOUSE BEHAVIORAL HEALTH AGENCY LEVEL 3 |
| Practice Address |
2733 W Michigan Ave Phoenix AZ 85053-1734 |
| Practice Telephone | 6235838086 |
| Mailing Telephone | 6235838086 |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2010-01-08 |
| Authorized Official Name | MR. SAUL WASSWA (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 6235838086 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH-3475 | AZ | Residential Treatment Facilities |
| Street Address |
2733 W MICHIGAN AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85053-1734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871065615 | Valley Addiction & Mental Health Services LLC | Nurse Practitioner | 16845 N. 29th Ave, Ste 1-211, Phoenix, AZ 85053 | 2018-12-18 |
| 1417439100 | Amanda M Sherwin | Dietitian, Registered | 15640 N 28h Drive, Phoenix, AZ 85053 | 2018-08-30 |
| 1568970135 | Sage Counseling, Inc. | Community/Behavioral Health | 2734 W Bell Rd., #1385 & 1390, Phoenix, AZ 85053 | 2018-01-17 |
| 1366966434 | Penny L Reamer | Registered Nurse | 17624 N. 31st Ave., Phoenix, AZ 85053 | 2017-08-01 |
| 1043749302 | Jacob Stephen Lawrence | Occupational Therapy Assistant | 3116 W. Hartford Dr., Phoenix, AZ 85053 | 2017-06-08 |
| 1770022923 | Horizon Dental Group West Valley | Dentist | 4025 W. Bell Road, Suite 20, Phoenix, AZ 85053 | 2017-02-21 |
| 1235594938 | Linda Thi Trinh | Optometrist | 16020 North 35th Ave Suite #2, Phoenix, AZ 85053 | 2015-12-22 |
| 1003230301 | Continuum Group West, LLC. | Clinic/Center | 3710 W Greenway Rd, Suite 104, Phoenix, AZ 85053 | 2014-02-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1437446580 | Candace Faith Gershkovich | Dentist | 4235 W. Thunderbird Rd, Phoenix, AZ 85053 | 2011-07-08 |
| Find all providers in zip 85053 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1043846561 | Happy Haven Az LLC | Community Based Residential Treatment Facility, Mental Illness | 1110 W Hadley St, Phoenix, AZ 85007-3610 | 2020-03-16 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| Find all providers in PHOENIX | ||||
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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.