HUDUMA HOUSE, LLC (NPI# 1851909964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851909964 |
| Entity Type | Organization |
| Organization Name | HUDUMA HOUSE, LLC |
| Practice Address |
6218 W Raymond St Phoenix AZ 85043 |
| Practice Telephone | 6026754861 |
| Mailing Telephone | 6026754861 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| Authorized Official Name | MR. ROBERT K. KOSKEI (HEALTHCARE ADMINISTRATOR) |
| Authorized Official Telephone | 6025169785 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102788 | Huduma House, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6221 W Illini St, Phoenix, AZ 85043-1915 | 2019-03-05 |
| Street Address |
6218 W RAYMOND ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073151171 | Erick Rotich | Behavior Technician | 6218 W Raymond St, Phoenix, AZ 85043-1918 | 2019-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1962936112 | Christine B Santa Cruz | Specialist/Technologist | 8101 W. Hammond Ln., Phoenix, AZ 85043 | 2017-04-14 |
| 1558704809 | Valley Independent Residential LLC | Community Based Residential Treatment Facility, Mental Illness | 6408 W Gross Ave, Phoenix, AZ 85043 | 2013-04-16 |
| 1275811598 | Diamond Manor Adult Care | Custodial Care Facility | 7330 W. Getty Drive, Phoenix, AZ 85043 | 2011-08-03 |
| 1821312877 | Bertha Romero | Case Manager/Care Coordinator | 7315 W Jones Ave, Phx, AZ 85043 | 2010-03-19 |
| 1477705788 | Patrick Lynn Perryman | Psychologist | 7250 W Buckeye Rd, Phoenix, AZ 85043 | 2008-10-17 |
| 1891910246 | Sammie Trotter | Technician | 5025 S. 24th Ave, Phoenix, AZ 85043 | 2007-04-13 |
| 1780719617 | German Dobson Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 6650 W. Lower Buckeye Rd, Phoenix, AZ 85043 | 2007-02-22 |
| 1992713689 | Occupational Health Center of The Southwest Pa | Clinic/Center | 5340 West Buckeye Road, Suite 3, Phoenix, AZ 85043 | 2006-08-04 |
| 1972523710 | William A Crane Jr. | Family Medicine | 7953 W Chickasaw St, Phoenix, AZ 85043 | 2006-07-21 |
| Find all providers in zip 85043 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536752 | The Heritage Behavioral Health Home LLC | Assisted Living Facility | 3927 W Rovey Ave, Phoenix, AZ 85019-1633 | 2020-07-29 |
| 1801420476 | Holy Trinity Behavioral,llc | Assisted Living Facility | 1630 W Nancy Ln, Phoenix, AZ 85041-5540 | 2020-02-23 |
| 1184258758 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5308 W Vernon Ave, Phoenix, AZ 85035-1953 | 2020-02-23 |
| 1083261945 | D&g Behavioral Health LLC | Assisted Living Facility | 3119 N 46th Dr, Phoenix, AZ 85031-3705 | 2019-08-24 |
| 1881249902 | A Tender Hand Assisted Living Home, LLC, Dba | Assisted Living Facility | 6216 S 36th St, Phoenix, AZ 85042-4904 | 2019-08-06 |
| 1265098339 | Affinity of Hope Care Home | Assisted Living Facility | 7518 S 15th Dr, Phoenix, AZ 85041-6935 | 2019-05-14 |
| 1538625744 | N & T Behavioral Health LLC | Assisted Living Facility | 6150 W Cheery Lynn Rd, Phoenix, AZ 85033-5833 | 2019-02-12 |
| 1104381300 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5208 W Avalon Dr, Phoenix, AZ 85031-3958 | 2019-02-01 |
| 1225592025 | Royal Behavioral Health LLC | Assisted Living Facility | 3845 W Mauna Loa Ln, Phoenix, AZ 85053-4538 | 2019-01-25 |
| 1629580717 | Brenton Casteel | Assisted Living Facility | 4638 E Summerhaven Dr, Phoenix, AZ 85044-4820 | 2017-10-29 |
| 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.