JANELLE HULTMAN


Address: 13401 W Fargo Dr, Surprise, AZ 85374-5205
Phone: 6235815687

JANELLE HULTMAN (NPI# 1952457392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952457392
Entity Type Organization
Organization Name JANELLE HULTMAN
Practice Address 13401 W Fargo Dr
Surprise
AZ 85374-5205
Practice Telephone 6235815687
Mailing Telephone 6235815687
Enumeration Date 2007-01-26
Last Update Date 2020-08-22
Authorized Official Name JANELLE EVONNE HULTMAN (ADMINISTRATOR)
Authorized Official Telephone 6235815687
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3104A0625X Assisted Living Facility
Specialization: Assisted Living, Mental Illness
BH-2695 AZ Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ 118632 05
AZ STATE LICENSE BH-2695 01

Office Location

Street Address 13401 W FARGO DR
City SURPRISE
State AZ
Zip Code 85374-5205

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1275005308 Filsan Ali Nurse Practitioner 14780 W Mountain View Blvd #109, Surprise, Az 85374, Surprise, AZ 85374 2018-12-31
1427528686 Anna L Bell Nurse Practitioner 14811 W Bell Rd Ste 100, Surprise, AZ 85374 2018-11-30
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Taxonomy Information

Taxonomy Code 3104A0625X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility
Specialization Assisted Living, Mental Illness

Taxonomy Definition

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]

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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
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Competitor

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City SURPRISE
Zip Code 85374

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Dataset Information

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.

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