NPIMap

Organization Active NPI

Arizona Homes of Miracles LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1053905208
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
ARIZONA HOMES OF MIRACLES LLC
Practice address
3205 S 63Rd LN
Phoenix, AZ 85043-1958
Phone
(623) 440-2377
NPI assigned
Feb 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Authorized official

Name
Abdisaak Mohamud
Title
Owner
Phone
(612) 306-0639

Specialties & licenses 1

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

Addresses

Primary practice location

3205 S 63Rd LN
Phoenix, AZ 85043-1958

Mailing address

3205 S 63Rd LN
Phoenix, AZ 85043-1958

National Provider Directory

National Provider Directory
Tax ID family
Arizona Homes of Miracles LLC2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1053905208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 S 63RD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 S 63RD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431958",
            "telephone_number": "623-440-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA HOMES OF MIRACLES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "ABDISAAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-306-0639"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.