JUSSAMAL MANOR 11 (NPI# 1770931966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770931966 |
| Entity Type | Organization |
| Organization Name | JUSSAMAL MANOR 11 |
| Practice Address |
641 S. Karen Dr. Chandler AZ 85224 |
| Practice Telephone | 4806218640 |
| Practice Fax Number | 4802573447 |
| Mailing Telephone | 4806218640 |
| Mailing Fax Number | 4802573447 |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |
| Authorized Official Name | MR. SAMUEL NJUGUNA MARIRA (CEO./PROGRAM DIRECTOR) |
| Authorized Official Telephone | 4805706245 |
| Authorized Official Credential | CEO. |
| 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 | BH4726 | AZ | Residential Treatment Facilities |
| Street Address |
641 S. KAREN DR. |
| City | CHANDLER |
| State | AZ |
| Zip Code | 85224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245878859 | Optum Infusion Services 308, LLC | Durable Medical Equipment & Medical Supplies | 460 S. Benson Lane, Ste. 11-12, Chandler, AZ 85224 | 2019-12-13 |
| 1073172037 | Brennan Allen | Dentist | 610 N Alma School Rd Ste 4, Chandler, AZ 85224 | 2019-06-12 |
| 1518525237 | Rachel Kelly Mador-house | Genetic Counselor, MS | 685 & 695 S Dobson Rd, Chandler, AZ 85224 | 2019-05-29 |
| 1780249748 | Julia Solomon, Md | Obstetrics & Gynecology | 1725 West Frye Road, Suite 120, Chandler, AZ 85224 | 2019-05-06 |
| 1487118717 | Litonrx LLC | Pharmacy | 2080 N. Dobson Road, Suite 3, Chandler, AZ 85224 | 2019-01-31 |
| 1528556495 | Stone Med, LLC | Physical Medicine & Rehabilitation | 77 S Dobson Rd., Phoenix, AZ 85224 | 2018-04-26 |
| 1144739079 | Four Peaks Anesthesia Consultants, LLC | Anesthesiology | 1900 W Chandler Blvd Ste 15-257, Chandler, AZ 85224 | 2017-09-22 |
| 1275061350 | Whitney Carter | Behavioral Analyst | 3200 N Dobson Rd Ste F-1, Chandler, AZ 85224 | 2017-06-01 |
| 1528509171 | Angela M. Navarrete | Specialist/Technologist, Other | 1586 W Maggio Way Apt 2005, 2005, Chandler, AZ 85224 | 2017-03-15 |
| 1063958288 | Glover Family Medical, LLC | Clinic/Center | 901 S Alma School Rd, Apt. 20, Chandler, AZ 85224 | 2017-01-11 |
| Find all providers in zip 85224 | ||||
| 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 |
| 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 |
| 1568740801 | Jussamal Manor | Community Based Residential Treatment Facility, Mental Illness | 3047 E Kingbird Pl, Chandler, AZ 85286-5615 | 2011-08-03 |
| 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 | ||||
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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.