KENNY JACOBS (NPI# 1447324397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447324397 |
| Entity Type | Individual |
| Full Name | KENNY JACOBS |
| Other Name | LATRECEE JACOBS |
| Practice Address |
8010 W Hilton Ave Phoenix AZ 85043-7420 |
| Practice Telephone | 6233225288 |
| Mailing Telephone | 6233225288 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
10730 | AZ | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID NUMBER | 113609 | 01 |
| Street Address |
8010 W HILTON AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85043-7420 |
| 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 | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
| 1912552381 | Leslie E Alfieri | Respite Care | 2250 E Deer Valley Rd Unit 48, Phoenix, AZ 85024-5530 | 2019-08-02 |
| 1811404437 | Montique S Collins | Respite Care | 729 W Maldonado Rd, Phoenix, AZ 85041-6763 | 2018-01-04 |
| 1801341441 | Asha Dey | Respite Care | 1914 W Carson Rd, Phoenix, AZ 85041-6658 | 2016-08-24 |
| 1811352016 | Megan Pirehpour | Respite Care | 25622 N Singbush Loop, Phoenix, AZ 85083-2457 | 2015-12-15 |
| 1093109050 | Ligia Ahumada | Respite Care | 7111 W Pioneer St, Phoenix, AZ 85043-7209 | 2015-03-26 |
| 1871914119 | Debbie Okojie | Respite Care | 4041 N 27th St Unit 110, Phoenix, AZ 85016-6773 | 2014-01-03 |
| 1578993895 | Ronald Harris | Respite Care | 2512 W Saint Catherine Ave, Phoenix, AZ 85041-5354 | 2013-11-22 |
| 1235569849 | Terry Jackson | Respite Care | 6605 S 18th Dr, Phoenix, AZ 85041-5841 | 2013-11-18 |
| 1245579895 | Annette Keil | Respite Care | 3901 E Emile Zola Ave, Phoenix, AZ 85032-6225 | 2013-02-01 |
| 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.