VISION GROUP HOME (NPI# 1497032668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497032668 |
| Entity Type | Organization |
| Organization Name | VISION GROUP HOME |
| Practice Address |
2917 W Bowker St Phoenix AZ 85041-3477 |
| Practice Telephone | 6233085414 |
| Practice Fax Number | 6023058619 |
| Mailing Telephone | 6233085414 |
| Mailing Fax Number | 6023058619 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | MRS. KETURAH MATTOX SHARPE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6233085414 |
| Authorized Official Credential | MBA, M ED, M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | BH3356 | AZ | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013117613 | Vision Group Home | Residential Treatment Facility, Emotionally Disturbed Children | 714 W Saint Kateri Dr, Phoenix, AZ 85041-5961 | 2007-07-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | VISION GROUP HOME CORPORATION | 14922 Se Gladstone St, Portland, OR 97236 |
| Street Address |
2917 W BOWKER ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85041-3477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558915843 | Our Home of Unity LLC | Counselor | 6804 S 21st Dr, Phoenix, AZ 85041 | 2019-07-25 |
| 1447816590 | Mbong Jerry Ngwese | Physical Therapist | 2546 West Bloch Rd, Phoenix, AZ 85041 | 2019-05-14 |
| 1588228373 | Arizona Dental Management | Dentist | 3515 West Southern Avenue, Suite #152, Phoenix, AZ 85041 | 2019-04-26 |
| 1447780135 | Mesa Dental Arizona LLC | Dentist | 3320 W Southern Ave #111, Phoenix, AZ 85041 | 2017-06-14 |
| 1932564697 | Job Elliott | Counselor | 4105 W Saint Charles Ave, Phoenix, AZ 85041 | 2015-12-23 |
| 1376914739 | Black Family and Child Services Inc | Community/Behavioral Health | 6811 West 33rd Ave, Phoenix, AZ 85041 | 2015-10-12 |
| 1972900983 | Love Living Life | Assisted Living Facility | 5737 S. 34th Ave, Phoenix, AZ 85041 | 2014-11-20 |
| 1891114641 | Maricopa County Special Health Care District | General Acute Care Hospital | 5650 S 35th Ave, Phoenix, AZ 85041 | 2014-04-09 |
| 1265616213 | Southern Dental | Dentist | 3320 W. Southern Avenue, Suite # 108, Phoenix, AZ 85041 | 2007-12-27 |
| 1518140086 | Arizona Cvs Stores,l.l.c. | Durable Medical Equipment & Medical Supplies | 7550 South 19th Ave, Phoenix, AZ 85041 | 2007-12-07 |
| Find all providers in zip 85041 | ||||
| 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 |
|---|---|---|---|---|
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
| 1023546819 | Zion Living | Residential Treatment Facility, Emotionally Disturbed Children | 1618 E Wood St, Phoenix, AZ 85040-1360 | 2017-05-24 |
| 1326400623 | Community Network Fellowship, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1839 N 39th St, Suite A, Phoenix, AZ 85008-3915 | 2016-03-25 |
| 1972910248 | Empower House LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2413 W Fetlock Trl, Phoenix, AZ 85085-5770 | 2014-07-17 |
| 1639596927 | Eagles Nest Group Home, Dba | Residential Treatment Facility, Emotionally Disturbed Children | 1802 E Dobbins Rd, Phoenix, AZ 85042-8500 | 2014-03-25 |
| 1548544463 | Cdh Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 4017 E La Puente Ave, Phoenix, AZ 85044-1339 | 2011-10-11 |
| 1760787527 | United Youth and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 33016 N 24th Ln, Phoenix, AZ 85085-6024 | 2011-01-25 |
| 1740500966 | Oasis Care Living, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6434 S 17th Pl, Phoenix, AZ 85042-4554 | 2010-06-10 |
| 1619299054 | House of Hope | Residential Treatment Facility, Emotionally Disturbed Children | 5814 S 11th St, Phoenix, AZ 85040-3177 | 2010-02-26 |
| 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.