MULLIGAN'S MANOR, INC. (NPI# 1427536770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427536770 |
| Entity Type | Organization |
| Organization Name | MULLIGAN'S MANOR, INC. |
| Practice Address |
4701 S Lakeshore Dr Unit 1 Tempe AZ 85282-7169 |
| Practice Telephone | 4808318721 |
| Practice Fax Number | 4802728708 |
| Mailing Telephone | 4808318721 |
| Mailing Fax Number | 4802728708 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | JENNIFER SAMAYOA DIAZ (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4808318727 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 217581 | 05 |
| Street Address |
4701 S LAKESHORE DR UNIT 1 |
| City | TEMPE |
| State | AZ |
| Zip Code | 85282-7169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346893575 | Cactus Canyon Dental | Dentist | 2043 E Southern Ave, Ste. C, Tempe, AZ 85282 | 2019-07-17 |
| 1023679644 | Donna Cooks | Registered Nurse | 233 E. Sourthern Ave #27702, Tempe, AZ 85282 | 2019-06-25 |
| 1841854932 | Lynn Stafford | Registered Nurse | 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-04-24 |
| 1598227340 | Jane Ramenofsky Ramenofsky Stewart | Registered Nurse | 4041 So. Mcclintock Suite 302, Tempe, AZ 85282 | 2019-04-02 |
| 1588129902 | Mary K Wheeler Mcfarland | Registered Nurse | Adobe Care and Wellness LLC, Address Is 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-02-11 |
| 1669949780 | Crestview Pharmacy Services LLC | Pharmacy | 3225 South Hardy Dr., Ste 100, Tempe, AZ 85282 | 2018-10-26 |
| 1275018715 | Berlin Wright | Naturopath | 2164 E. Broadway Rd., Tempe, AZ 85282 | 2018-10-01 |
| 1043701543 | Lakeshore Interventional Treatment Center LLC | Surgery | 4765 S Lakeshore Dr, Tempe, AZ 85282 | 2018-05-21 |
| 1427553940 | The Bridge Counseling, Consulting and Mediation LLC | Counselor | 4625 S. Lakeshore Dr., 302, Tempe, AZ 85282 | 2018-03-27 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| Find all providers in zip 85282 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467200 | Monique M Gomez | Counselor | 3923 S Willow Dr, Tempe, AZ 85282-5761 | 2020-11-08 |
| 1811504004 | Shadetree Wellness Center of Arizona LLC | Counselor | 2737 W Baseline Rd Ste 21, Tempe, AZ 85283-1051 | 2020-09-30 |
| 1447867858 | Stacy Marie Bliss-lefebvre | Counselor | 2111 E Baseline Rd Ste B3, Tempe, AZ 85283-1517 | 2020-09-29 |
| 1407463078 | Aaron Bachler | Counselor | 2111 E Baseline Rd Ste C7, Tempe, AZ 85283-1521 | 2020-09-28 |
| 1538773635 | Audrey Stanley | Counselor | 13 E Carter Dr, Tempe, AZ 85282-6702 | 2020-09-04 |
| 1518571884 | Kristi Marie Plinski | Counselor | 2111 E Baseline Rd Ste B1, Tempe, AZ 85283-1517 | 2020-09-03 |
| 1730793282 | Tyler Michael Kees I | Counselor | 1730 E Mcnair Dr, Tempe, AZ 85283-5000 | 2020-09-02 |
| 1336750264 | Jaxinta Silvia Shaffer | Counselor | 104 E Garfield St, Tempe, AZ 85281-1011 | 2020-08-13 |
| 1376153056 | Amy Fleur Leiferman | Counselor | 8727 S Priest Dr Ste 101, Tempe, AZ 85284-1915 | 2020-08-06 |
| 1619500972 | Natasha De Soysa | Counselor | 401 W Baseline Rd Ste 210, Tempe, AZ 85283-5350 | 2020-02-14 |
| Find all providers in TEMPE | ||||
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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.