SHORELINE BEHAVIORAL HEALTH, LLC (NPI# 1831740547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831740547 |
Entity Type | Organization |
Organization Name | SHORELINE BEHAVIORAL HEALTH, LLC |
Practice Address |
4514 W Hasan Dr Laveen AZ 85339-1959 |
Mailing Address |
1816 W Magdalena Ln Phoenix AZ 85041-7815 |
Practice Telephone | 6232135356 |
Mailing Telephone | 6232135356 |
Mailing Fax Number | 4803836782 |
Enumeration Date | 2019-09-24 |
Last Update Date | 2019-09-24 |
Authorized Official Name | SADE COLLINS (DIRECTOR) |
Authorized Official Telephone | 6232135356 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
N | 251S00000X | Community/Behavioral Health | Agencies | ||
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
Address | Telephone Number | Fax Number |
---|---|---|
1816 W Magdalena Ln, Phoenix, AZ 850417815 | 6232135356 | 4803836782 |
Street Address |
4514 W HASAN DR |
City | LAVEEN |
State | AZ |
Zip Code | 85339-1959 |
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 | 324500000X |
Grouping | Residential Treatment Facilities |
Classification | Substance Abuse Rehabilitation Facility |
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
Notes: [7/1/2003: modified title, modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730485822 | Gila River Health Care | Substance Abuse Rehabilitation Facility | 3850 North 16th Street, Laveen, AZ 85339 | 2011-02-07 |
1073755013 | Gila River Indian Community Department of Human Services | Substance Abuse Rehabilitation Facility | 3850 N. 16 Street, Laveen, AZ 85339 | 2009-04-06 |
1265849939 | Destiny Sober Living II Carver Ranch | Substance Abuse Rehabilitation Facility | 11629 S 43rd Ave, Laveen, AZ 85339-3245 | 2014-07-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669073920 | Tusa Mental Health Services LLC | Substance Abuse Rehabilitation Facility | 11570 East Cornville Road, Cornville, AZ 86325 | 2020-11-03 |
1578170999 | Arizona Center for Recovery- A New Direction | Substance Abuse Rehabilitation Facility | 5331 N Sundown Dr, Tucson, AZ 85718-5515 | 2020-09-29 |
1427663947 | Summit Bhc Tuscon, LLC | Substance Abuse Rehabilitation Facility | 4210 W. Sweetwater Drive, Tucson, AZ 85745-9348 | 2020-09-11 |
1386254027 | J & B Assisted Living, Inc. D/b/a J & B Behavioral Health II | Substance Abuse Rehabilitation Facility | 6613 W. Pershing Avenue, Glendale, AZ 85304 | 2020-08-07 |
1932726361 | Northstar Homecare LLC | Substance Abuse Rehabilitation Facility | 5239 S 33rd Dr, Phoenix, AZ 85041-7411 | 2020-07-01 |
1891312542 | Semper Fidelis Behavioral Health Care, LLC | Substance Abuse Rehabilitation Facility | 8020 N 17th Dr, Phoenix, AZ 85021-5217 | 2020-06-29 |
1558988246 | Cmj Recovery Az LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg A, Phoenix, AZ 85016-5922 | 2020-06-29 |
1780201772 | Pinnacle Peak Recovery, LLC | Substance Abuse Rehabilitation Facility | 8070 E Morgan Trl Ste 125, Scottsdale, AZ 85258-1228 | 2020-06-25 |
1629692025 | A Home 4 U Transitional Housing | Substance Abuse Rehabilitation Facility | 18474 E Kingbird Dr, Queen Creek, AZ 85142-5118 | 2020-06-01 |
1568085215 | Scottsdale Recovery II, LLC | Substance Abuse Rehabilitation Facility | 10227 N Scottsdale Road, Scottsdale, AZ 85253-8526 | 2020-05-28 |
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.