NPIMap

Organization Active NPI

Home Away From Home Behavioral Health Residential Facility

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Peoria, AZ
National Provider Identifier
1053702563
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH4513 Issued in AZ
Legal business name
HOME AWAY FROM HOME BEHAVIORAL HEALTH RESIDENTIAL FACILITY
Practice address
8572 W Palo Verde Ave
Peoria, AZ 85345-5354
Phone
(623) 312-3485
NPI assigned
Feb 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Mrs. Tanya M Ayiyi
Title
Administrator
Phone
(623) 312-3485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH4513 AZ Primary

Addresses

Primary practice location

8572 W Palo Verde Ave
Peoria, AZ 85345-5354

Mailing address

8572 W Palo Verde Ave
Peoria, AZ 85345-5354
Phone (623) 312-3485

National Provider Directory

National Provider Directory
Tax ID family
Home Away From Home Behavioral Health Residential2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1053702563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8572 W PALO VERDE AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455354",
            "telephone_number": "623-312-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8572 W PALO VERDE AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853455354",
            "telephone_number": "623-312-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME AWAY FROM HOME BEHAVIORAL HEALTH RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "AYIYI",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "623-312-3485",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH4513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.