EUREKA IMPERIAL RESIDENCE (NPI# 1649798752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649798752 |
| Entity Type | Organization |
| Organization Name | EUREKA IMPERIAL RESIDENCE |
| Other Organization Name | CHANGING LIVES OUTPATIENT CENTER |
| Practice Address |
633 E Ray Road Gilbert AZ 85295 |
| Mailing Address |
633 E Ray Rd Gilbert AZ 85296-4200 |
| Practice Telephone | 4802642647 |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2017-09-08 |
| Authorized Official Name | CORNELIUS TANYI (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 4802642647 |
| Is Organization Subpart | Y |
| Parent Organization Name | EUREKA IMPERIAL RESIDENCE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CHANGING LIVES OUTPATIENT CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679704381 | Eureka Imperial Residence | Community Based Residential Treatment Facility, Mental Illness | 1740 S Heritage Drive, Gilbert, AZ 85296 | 2009-07-29 |
| Street Address |
633 E RAY ROAD |
| City | GILBERT |
| State | AZ |
| Zip Code | 85295 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471368 | Lifequest Holding Company Gilbert, LLC | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd Suite 101, Gilbert, AZ 85295 | 2020-09-09 |
| 1255946075 | Lifequest Physical Medicine and Rehab | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd. Suite 101, Gilbert, AZ 85295 | 2020-09-09 |
| 1407467962 | Lifequest Physical Medicine and Rehab | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd, Suite 101, Gilbert, AZ 85295 | 2020-08-10 |
| 1275187718 | Guylene Lucien | Nurse Practitioner | 1689 S. Parkcrest Street, Gilbert, AZ 85295 | 2019-08-01 |
| 1326607144 | Hand Up Behavioral Services, LLC | Community/Behavioral Health | 4145 East Megan Street, Gilbert, AZ 85295 | 2019-06-06 |
| 1629582069 | Victoria Munoz Garcia | Naturopath | 920 S Williams Field Rd., Ste 102, Gilbert, AZ 85295 | 2017-11-21 |
| 1447791496 | Janine Patrice Faux | Counselor | 2563 S. Val Vista Drive St. 108, Gilbert, AZ 85295 | 2017-03-10 |
| 1437690450 | Erskine & Barber LLC | Clinic/Center | 5656 S. Power Rd #129, Gilbert, AZ 85295 | 2017-03-09 |
| 1164965448 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 774 E. Buffalo St, Chandler, AZ 85295 | 2016-11-18 |
| 1912370578 | Americas Billing Solution LLC | General Acute Care Hospital | 2730 S. Val Vista Drive, #129, Gilbert, AZ 85295 | 2015-11-04 |
| Find all providers in zip 85295 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629560941 | Women's Health Innovations of Arizona | Clinic/Center | 3303 S Lindsay Rd Ste 108, Gilbert, AZ 85297-1504 | 2018-06-01 |
| 1396232344 | Exhale Counseling Services, LLC | Clinic/Center | 2730 S Val Vista Dr Ste 115, Gilbert, AZ 85295-1676 | 2018-04-16 |
| 1457466815 | Red Mountain Behavioral Health Services, LLC | Clinic/Center | 2915 E Baseline Rd Ste 115, Gilbert, AZ 85234-2427 | 2006-08-19 |
| 1942808761 | My Help My Way, P.C. | Clinic/Center | 1530 E Williams Field Rd Ste 201, Gilbert, AZ 85295-1825 | 2020-10-14 |
| 1578951448 | Southwestern Children's Health Services, Inc. | Clinic/Center | 1425 S Higley Rd Ste 104, Gilbert, AZ 85296-4798 | 2014-12-31 |
| 1831378793 | Banner Psychological Services | Clinic/Center | 1920 N Higley Rd, Suite 106, Gilbert, AZ 85234-1623 | 2007-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475144 | Best Self LLC | Clinic/Center | 10000 N 31st Ave Ste C100-128, Phoenix, AZ 85051-1356 | 2020-10-24 |
| 1932716594 | High End Health Care Professionals LLC | Clinic/Center | 10840 N Buffalo Dr, Fountain Hills, AZ 85268-5348 | 2020-09-28 |
| 1164039723 | Life Care Premier Services LLC | Clinic/Center | 4690 S Lakeshore Dr Apt 3052, Tempe, AZ 85282-1174 | 2020-09-28 |
| 1215544903 | Supreme Positive Innovation Services LLC | Clinic/Center | 1833 W Main St Ste 139-140, Mesa, AZ 85201-6922 | 2020-09-26 |
| 1316554421 | Essential Wellness Solutions LLC | Clinic/Center | 345 N 79th Pl, Mesa, AZ 85207-7570 | 2020-09-23 |
| 1659986636 | Cactus Blossom Counseling, Pllc | Clinic/Center | 1616 W Germann Rd Apt 2019, Chandler, AZ 85286-6984 | 2020-09-15 |
| 1164036935 | Carmen L. Lucia Psyd LLC | Clinic/Center | 15215 S 48th St Ste 154, Phoenix, AZ 85044-9139 | 2020-08-31 |
| 1366054694 | Integrative Counseling L.L.C. | Clinic/Center | 2211 E Highland Ave Ste 130, Phoenix, AZ 85016-4867 | 2020-08-18 |
| 1811507379 | Aptitude Mental Health Pllc | Clinic/Center | 5025 S Ash Ave Ste 12, Tempe, AZ 85282-6885 | 2020-08-08 |
| 1730798562 | Healthier Ever After LLC | Clinic/Center | 65 S Sycamore Ste 2, Mesa, AZ 85202-1143 | 2020-07-28 |
| Find all providers with the same taxonomy | ||||
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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.