JUSSAMAL MANOR (NPI# 1568740801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568740801 |
| Entity Type | Organization |
| Organization Name | JUSSAMAL MANOR |
| Practice Address |
3047 E Kingbird Pl Chandler AZ 85286-5615 |
| Mailing Address |
1302 W Kesler Ln Chandler AZ 85224-7286 |
| Practice Telephone | 4802687738 |
| Practice Fax Number | 4802687738 |
| Mailing Telephone | 9515676673 |
| Mailing Fax Number | 4802687738 |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-08-03 |
| Authorized Official Name | MR. SAMUEL NJUGUNA MARIRA (CEO/PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9515676673 |
| Is Organization Subpart | Y |
| Parent Organization Name | JUSSAMAL MANOR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH3838 | AZ | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| 0 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639493406 | Jussamal Manor | Behavioral Analyst | 1302 W Kesler Ln, Chandler, AZ 85224-7286 | 2010-03-22 |
| Street Address |
3047 E KINGBIRD PL |
| City | CHANDLER |
| State | AZ |
| Zip Code | 85286-5615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780202804 | Cep America- Arizona, PC | Emergency Medicine | 1405 S. Alma School Rd., Chandler, AZ 85286 | 2020-07-07 |
| 1972139004 | Banner Health | General Acute Care Hospital | 1405 S Alma School Rd, Chandler, AZ 85286 | 2020-03-20 |
| 1033776455 | Premier Orthodontic Specialists Pllc | Dentist | 3230 S. Gilbert Rd. Ste. 1, Chandler, AZ 85286 | 2019-05-21 |
| 1871056978 | Erica Satoko Sugiyama-hill | Counselor | 3042 West Queen Creek Rd, Chandler, AZ 85286 | 2019-04-08 |
| 1235693169 | Shumway Dental Care Pllc | Dentist | 3150 S. Gilbert Road Suite 1, Chandler, AZ 85286 | 2019-01-24 |
| 1568968287 | Reita Jenae Juarez | Counselor | 3042 W Queen Creek Road, Chandler, AZ 85286 | 2018-04-02 |
| 1205348984 | Seriously Speaking, LLC. | Speech-Language Pathologist | 650 E. Woodsman Place, Chandler, AZ 85286 | 2017-11-02 |
| 1689194920 | Kyle D. Byrne | Physician Assistant | 1100 S Dobson Rd Ste 203, Chandler, AZ 85286 | 2017-06-27 |
| 1053844183 | Omar Faisal Saleem | Internal Medicine | 1405 S Alma School Road, Attn Amanda Gump/ Hospitalists, Chandler, AZ 85286 | 2017-04-05 |
| 1629427539 | Bryanda Silva | Specialist/Technologist | 2350 E Germann Rd #33, Chandler, AZ 85286 | 2016-06-10 |
| Find all providers in zip 85286 | ||||
| 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 |
|---|---|---|---|---|
| 1598387490 | Serenity Residential Homes, LLC | Community Based Residential Treatment Facility, Mental Illness | 101 W Hackberry Dr, Chandler, AZ 85248-4012 | 2020-05-13 |
| 1679118848 | Jf Residential LLC | Community Based Residential Treatment Facility, Mental Illness | 2225 W Frye Rd, Chandler, AZ 85224-6477 | 2019-11-12 |
| 1073175048 | A Brighter Day Living Center LLC | Community Based Residential Treatment Facility, Mental Illness | 264 N Exeter St, Chandler, AZ 85225-4657 | 2019-06-30 |
| 1003314428 | Victory Manor LLC. | Community Based Residential Treatment Facility, Mental Illness | 1041 S Yucca Pl, Chandler, AZ 85286-0982 | 2018-01-31 |
| 1770931966 | Jussamal Manor 11 | Community Based Residential Treatment Facility, Mental Illness | 641 S. Karen Dr., Chandler, AZ 85224 | 2016-05-27 |
| 1598124075 | Pastalino Manor LLC 3 | Community Based Residential Treatment Facility, Mental Illness | 2264 W Olive Way, Chandler, AZ 85248-4184 | 2016-02-12 |
| 1881001832 | Better Horizons LLC | Community Based Residential Treatment Facility, Mental Illness | 2204 E Firestone Dr, Chandler, AZ 85249-4636 | 2014-07-22 |
| 1487923439 | Winding Woods Manor L,l.c. | Community Based Residential Treatment Facility, Mental Illness | 3691 S Ashley Pl, Chandler, AZ 85286-2618 | 2011-12-20 |
| 1396057600 | Odel Burnes Sr. | Community Based Residential Treatment Facility, Mental Illness | 3268 E Goldfinch Way, Chandler, AZ 85286-5732 | 2010-07-02 |
| 1174703995 | Osceola Bowlin Inc | Community Based Residential Treatment Facility, Mental Illness | 2144 E Indian Wells Dr, Chandler, AZ 85249-4865 | 2007-11-08 |
| Find all providers in CHANDLER | ||||
Please comment or provide details below to improve the information on JUSSAMAL MANOR.
| 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.