SOUTH MOUNTAIN HOLISTIC CARE (NPI# 1770038564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770038564 |
| Entity Type | Organization |
| Organization Name | SOUTH MOUNTAIN HOLISTIC CARE |
| Practice Address |
3219 W Olney Ave Laveen AZ 85339-1783 |
| Mailing Address |
3219 W Olney Ave Laveen AZ 85339 |
| Practice Telephone | 6025655909 |
| Mailing Telephone | 6025655909 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |
| Authorized Official Name | MS. STEPHANIE LYNN BRIGHAM (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6025655909 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | BH4914 | AZ | Nursing & Custodial Care Facilities |
| Street Address |
3219 W OLNEY AVE |
| City | LAVEEN |
| State | AZ |
| Zip Code | 85339-1783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093351611 | Nationwide Vision Center, LLC | Technician/Technologist | 7650 S 59th Ave, Suite 101, Laveen, AZ 85339 | 2019-11-19 |
| 1164074282 | Alvis Lee Robertson | Counselor | 3850 N. 16th St. E. Beltline Rd., Laveen, AZ 85339 | 2019-07-09 |
| 1912493933 | Kristine Robles | Specialist/Technologist | 6501 W Alta Vista Rd, Laveen, AZ 85339 | 2018-07-02 |
| 1366968521 | Care Line, LLC | Home Health | 5818 West Pedro Lane, Laveen, AZ 85339 | 2017-08-19 |
| 1881119550 | Calvary Home Care Services Inc | Day Training, Developmentally Disabled Services | 4360 W. Alta Vista Rd, Laveen, AZ 85339 | 2017-08-03 |
| 1295284354 | Brian Hiapo Jr. | Assistant, Podiatric | 6170 S 51st Ave Ste 103, Laveen, AZ 85339 | 2016-09-29 |
| 1962850073 | Laveen Pediatric Dental Partners, LLP | Dentist | 5235 W. Baseline Rd, Ste 187, Laveen, AZ 85339 | 2016-05-31 |
| 1619353992 | Tiffany Lee | Specialist/Technologist | 7034 S. 64ave, Laveen, AZ 85339 | 2015-08-10 |
| 1558759068 | Makoto Wakamori | Counselor | 3850 North 16th Street Laveen Az 85339, Laveen, AZ 85339 | 2015-01-06 |
| 1568850329 | Gila River Health Care Corporation | Community Based Residential Treatment Facility, Mental Illness | 142226 S 53rd Ave, Laveen, AZ 85339 | 2015-01-02 |
| Find all providers in zip 85339 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073007423 | Nani's Home | Intermediate Care Facility, Mental Illness | 4267 W Calle Don Clemente, Tucson, AZ 85746-8500 | 2018-06-19 |
| 1134676166 | Papa's Home | Intermediate Care Facility, Mental Illness | 8784 E Desert Lupine Pl, Tucson, AZ 85715-5911 | 2016-09-07 |
| 1760831507 | A-plus Care, LLC | Intermediate Care Facility, Mental Illness | 1626 E Dust Devil Dr, San Tan Valley, AZ 85143-4447 | 2016-06-11 |
| 1902250616 | Juniper Home | Intermediate Care Facility, Mental Illness | 10221 E Juniper Basin Ln, Tucson, AZ 85748-6767 | 2016-04-19 |
| 1396107041 | Carmen's Home | Intermediate Care Facility, Mental Illness | 7466 E 18th St, Tucson, AZ 85710-4907 | 2016-03-22 |
| 1104091701 | The Excel Group | Intermediate Care Facility, Mental Illness | 106 E 1st St, Yuma, AZ 85364-1450 | 2008-04-24 |
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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.