KRYSTAL COLLINS (NPI# 1477979607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477979607 |
Entity Type | Individual |
Full Name | KRYSTAL COLLINS |
Practice Address |
21010 S 220th Pl Queen Creek AZ 85142-5583 |
Practice Telephone | 6025022388 |
Enumeration Date | 2014-03-12 |
Last Update Date | 2014-03-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 514514 | AZ | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | PROFESSIONAL FOSTER PARENT | 5807215 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780230375 | Krystal Collins | Nurse Practitioner | 9800 Baptist Health Dr Ste 600, Little Rock, AR 72205-6244 | 2019-08-10 |
1811401409 | Krystal Alexandra Collins | Speech-Language Pathologist | 135 River St, New Canaan, CT 06840-4236 | 2017-11-19 |
1003341686 | Krystal Jacquelle Collins | Counselor | 104 Sassafras St, Amite, LA 70422-3425 | 2017-04-20 |
1285920199 | Krystal L Collins | Community Health Worker | 325 Sw Frazier Ave, Topeka, KS 66606-1963 | 2011-06-20 |
1669799169 | Krystal Ann Collins | Nurse Practitioner | 801 N Weisgarber Rd, Suite 200, Knoxville, TN 37909-2706 | 2010-04-23 |
Street Address |
21010 S 220TH PL |
City | QUEEN CREEK |
State | AZ |
Zip Code | 85142-5583 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093346033 | Arizona Dental Professionals, P.C. | Dentist | 20311 S Ellsworth Rd Ste 101, Queen Creek, AZ 85142 | 2020-01-29 |
1073158903 | Jonathan Corey Barber | Physical Therapy Assistant | 22424 South Ellsworth Loop Road, #464, Queen Creek, AZ 85142 | 2019-11-14 |
1689142333 | Erin Sohr | Occupational Therapy Assistant | 4594 W Federal Way, San Tan Valley, AZ 85142 | 2018-11-10 |
1083180723 | Katelyn Hannabach | Physician Assistant | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142 | 2018-10-20 |
1043701899 | Brittany Leigh Amor | Dentist | 18550 E Rittenhouse Rd Ste 103, Queen Creek, AZ 85142 | 2018-05-28 |
1861925604 | Shani Thompson | Student in an Organized Health Care Education/Training Program | 22437 S 209th Way, Queen Creek, AZ 85142 | 2017-04-08 |
1689115164 | 360 Physical Therapy LLC | Physical Therapist | 21576 S Ellsworth Loop Rd, 150, Queen Creek, AZ 85142 | 2017-03-16 |
1891233714 | Candee J. Eisenhart | Nurse Practitioner | 21321 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142 | 2017-02-11 |
1790231546 | Carrie Church | Nurse Practitioner | 20185 E Ocotillo Rd Ste 104, Queen Creek, AZ 85142 | 2016-08-31 |
1669836649 | Horizon Health and Wellness, Inc. | Community/Behavioral Health | 22713 S. Ellsworth Road, Building A, Queen Creek, AZ 85142 | 2016-04-06 |
Find all providers in zip 85142 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588998520 | P.o.w.e.r. House Youth Facility | Residential Treatment Facility, Emotionally Disturbed Children | 3039 E Superior Rd, Queen Creek, AZ 85143-4580 | 2009-09-23 |
1174774608 | Yajcinllc | Residential Treatment Facility, Emotionally Disturbed Children | 1609 E Heather Dr, Queen Creek, AZ 85240-5682 | 2008-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528666039 | Rehoboth LLC | Residential Treatment Facility, Emotionally Disturbed Children | 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 | 2020-10-16 |
1962022665 | New Hope of Arizona, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8710 W Watkins St, Tolleson, AZ 85353-9028 | 2020-04-22 |
1639798143 | Anthony Udoinwang | Residential Treatment Facility, Emotionally Disturbed Children | 10435 W Reade Ave, Glendale, AZ 85307-4237 | 2020-04-14 |
1033756358 | Native Music Coalition | Residential Treatment Facility, Emotionally Disturbed Children | 5150 S Crazy Cat Ln, Tucson, AZ 85735 | 2019-12-05 |
1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
1487118865 | Serenity Preferred LLC | Residential Treatment Facility, Emotionally Disturbed Children | 17829 W Columbine Dr, Surprise, AZ 85388-5628 | 2019-01-30 |
1407333958 | Copa's Caring Hands LLC. | Residential Treatment Facility, Emotionally Disturbed Children | 42251 W Bravo Dr, Maricopa, AZ 85138-2295 | 2018-07-26 |
1538668983 | Starks Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7325 E Fayette St, Tucson, AZ 85730-2324 | 2018-02-12 |
1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
1033625926 | Youth Transition Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1190 S Boulder St Unit D, Gilbert, AZ 85296-3792 | 2017-12-14 |
Find all providers with the same taxonomy |
City | QUEEN CREEK |
Zip Code | 85142 |
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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.