1514 BETHANY HOME MANAGEMENT, LLC (NPI# 1801369632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801369632 |
| Entity Type | Organization |
| Organization Name | 1514 BETHANY HOME MANAGEMENT, LLC |
| Practice Address |
1514 W Bethany Home Rd Phoenix AZ 85015-2504 |
| Mailing Address |
14362 N Frank Lloyd Wright Blvd Ste 1000 Scottsdale AZ 85260-8847 |
| Practice Telephone | 6028886779 |
| Mailing Telephone | 4803840789 |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-01-03 |
| Authorized Official Name | MR. JAMES GUAJARDO (MANAGER) |
| Authorized Official Telephone | 4803840789 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
1514 W BETHANY HOME RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| 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 |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1043846561 | Happy Haven Az LLC | Community Based Residential Treatment Facility, Mental Illness | 1110 W Hadley St, Phoenix, AZ 85007-3610 | 2020-03-16 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| 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.