AZ PEACE OF MIND BEHAVIORAL HEALTH HOME LLC (NPI# 1821616319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821616319 |
| Entity Type | Organization |
| Organization Name | AZ PEACE OF MIND BEHAVIORAL HEALTH HOME LLC |
| Practice Address |
15622 W Sierra St Surprise AZ 85379-1038 |
| Practice Telephone | 6232146420 |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |
| Authorized Official Name | ELVINE MUTETERI (ADMINISTRATOR) |
| Authorized Official Telephone | 6232146420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units | ||
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Street Address |
15622 W SIERRA ST |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85379-1038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841818887 | Arizona Heartlands Home Care, LLC | Adult Companion | 14626 W. Wethersfield Rd, Surprise, AZ 85379 | 2020-07-07 |
| 1740832351 | Amanda Deangelis | Specialist/Technologist | 14064 W. Poinsettia Dr., Surprise, AZ 85379 | 2019-07-13 |
| 1720550767 | Anastasia Assisted Living Home LLC | Assisted Living Facility | 12805 N 145th Ave, Surprise, AZ 85379 | 2018-12-31 |
| 1306355821 | National Vision, Inc. | Technician/Technologist | Loop 303, Surprise, AZ 85379 | 2017-09-27 |
| 1306365770 | Christopher Albert Gard | Nurse Practitioner | 15643 W Cameron Dr, Surprise, AZ 85379 | 2017-09-16 |
| 1336667096 | Leon Quoc Lai | Pharmacist | 13723 Litchfield Rd, Surprise, AZ 85379 | 2017-09-01 |
| 1134664451 | Princess Valentin | Nurse Practitioner | 15400 W Waddell Road, Surprise, AZ 85379 | 2016-12-21 |
| 1871952408 | James Care Associates LLC | In Home Supportive Care | 12720 N. 149th Lane, Surprise, AZ 85379 | 2016-02-10 |
| 1669861688 | Todd Cleland | Physical Therapist | 15384 W. Dahlia Drive, Surprise, AZ 85379 | 2015-01-14 |
| 1326442187 | Sarpotdar Orthodontics, Pllc | Dentist | 13775 N. Litchfield Rd, Suite 108, Surprise, AZ 85379 | 2014-10-22 |
| Find all providers in zip 85379 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952457392 | Janelle Hultman | Assisted Living Facility | 13401 W Fargo Dr, Surprise, AZ 85374-5205 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174120703 | Charite Home | Assisted Living Facility | 6057 S Avenida Caneca, Tucson, AZ 85706-5073 | 2020-10-06 |
| 1245847664 | Young Life Al Inc. | Assisted Living Facility | 2334 W Rancho Dr, Phoenix, AZ 85015-2211 | 2020-09-29 |
| 1184231953 | Frontier Home Health Care Sober Living of Arizona, Corp | Assisted Living Facility | 8604 N 43rd Dr, Glendale, AZ 85302-5317 | 2020-09-25 |
| 1679180517 | Trinity's House | Assisted Living Facility | 6692 E Via Boca Chica, Tucson, AZ 85756-8309 | 2020-09-24 |
| 1811526148 | Phoenix Comfort Homes LLC | Assisted Living Facility | 17643 N 17th St, Phoenix, AZ 85022-2113 | 2020-04-07 |
| 1508493016 | Good Care Network LLC | Assisted Living Facility | 4775 E Kristen Dr, Prescott, AZ 86301-5803 | 2020-03-25 |
| 1881229946 | Famiglia Amore II LLC | Assisted Living Facility | 632 N. Wilmot, Tucson, AZ 85711 | 2020-03-10 |
| 1669002168 | Better Horizons Behavioral Health LLC | Assisted Living Facility | 1136 W Fever Tree Ave, San Tan Valley, AZ 85140-7682 | 2020-01-23 |
| 1225697386 | Alpine Villa LLC | Assisted Living Facility | 2144 W Luke Ave, Phoenix, AZ 85015-2319 | 2019-06-11 |
| 1225510118 | Adagio Luxury 4 LLC | Assisted Living Facility | 1045 E Bethany Home Rd, Phoenix, AZ 85014-2229 | 2018-09-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AZ PEACE OF MIND BEHAVIORAL HEALTH HOME LLC.
| 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.