NPIMap

Organization Active NPI

Joondalup Prestige LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Laveen, AZ
National Provider Identifier
1003577222
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
JOONDALUP PRESTIGE LLC
Practice address
8509 S 41St Dr
Laveen, AZ 85339-7823
Phone
(858) 344-4746
Fax
(480) 546-4743
NPI assigned
Jan 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Mercy Wendy Muthoni, MD
Title
Administrator
Phone
(858) 344-4746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

8509 S 41St Dr
Laveen, AZ 85339-7823

Mailing address

8509 S 41St Dr
Laveen, AZ 85339-7823
Phone (858) 344-4746

Other names 1

  • JOONDALUP PRESTIGE BEHAVIORAL HOME Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jprestigellc@gmail.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Joondalup Prestige LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1003577222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8509 S 41ST DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397823",
            "telephone_number": "858-344-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8509 S 41ST DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397823",
            "telephone_number": "858-344-4746",
            "fax_number": "480-546-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOONDALUP PRESTIGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "MUTHONI",
        "authorized_official_first_name": "MERCY",
        "authorized_official_middle_name": "WENDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "858-344-4746",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jprestigellc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Direct messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "8509 S 41st Dr",
            "city": "Laveen",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853397823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "JOONDALUP PRESTIGE BEHAVIORAL HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.