Active NPI
Grace of Serenity Living, Inc
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Peoria, AZ
National Provider Identifier
1114197969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- License
- BH2333
- Legal business name
- GRACE OF SERENITY LIVING, INC
- Practice address
- 8340 N 86TH LN
Peoria, AZ 85345-2553 - Phone
- (602) 441-4690
- NPI assigned
- Mar 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Tammy R Meade
- Title
- Ceo
- Phone
- (602) 441-4690
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | BH2333 | AZ | Primary |
Addresses
Primary practice location
8340 N 86TH LN
Peoria, AZ 85345-2553
Mailing address
2720 E Thomas Rd
B-200
Phoenix, AZ 85016-8299
Phone (602) 441-4690
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 816803 | Other | AZ | AHCCS |
National Provider Directory
National Provider Directory- Tax ID family
- Grace of Serenity Living
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Illness Community Based Residential Treatment Facility
- Phoenix, AZ
- NPI 1497925242
-
- Mental Illness Community Based Residential Treatment Facility
- Phoenix, AZ
- NPI 1770805012
-
- Community/Behavioral Health Agency
- Phoenix, AZ
- NPI 1528184959
Locations
2720 E Thomas Rd
Ste 200B
Phoenix, AZ 85016
Phone (800) 689-6958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204848000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204848000000",
"number": "1114197969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2720 E THOMAS RD",
"address_2": "B-200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850168299",
"telephone_number": "602-441-4690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8340 N 86TH LN",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853452553",
"telephone_number": "602-441-4690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRACE OF SERENITY LIVING, INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-07",
"last_updated": "2008-03-07",
"status": "A",
"authorized_official_last_name": "MEADE",
"authorized_official_first_name": "TAMMY",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "602-441-4690",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": "AZ",
"license": "BH2333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCS",
"identifier": "816803",
"state": "AZ"
}
],
"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 Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.