Active NPI
Angel Heart Behavioral Health III LLC
- Psychiatric Residential Treatment Facility
- Phoenix, AZ
National Provider Identifier
1114552122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Residential Treatment Facility
- Legal business name
- ANGEL HEART BEHAVIORAL HEALTH III LLC
- Practice address
- 9223 W Meadow Brook
9223 W Meadow Brook Ave
Phoenix, AZ 85037-8503 - Phone
- (207) 409-6515
- NPI assigned
- Mar 10, 2020
- 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
- Aimee Nyirakanyana
- Title
- Program Operating Officer
- Phone
- (623) 777-0427
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Residential Treatment Facility | 323P00000X | Primary |
Addresses
Primary practice location
9223 W Meadow Brook
9223 W Meadow Brook Ave
Phoenix, AZ 85037-8503
Mailing address
9223 W Meadowbrook Ave
Phoenix, AZ 85037-2442
Phone (207) 409-6515
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003 | Medicaid | AZ | |
| 0000 | Other | AZ | NO OTHER IDENTIFICATION NUMBER AVAILABLE |
Other names 1
- ANGEL HEART BEHAVIORAL HEALTH III LLC
National Provider Directory
National Provider Directory- Tax ID family
- Angel Heart Behavavioral Health
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Phoenix, AZ
- NPI 1023655040
-
- Community/Behavioral Health Agency
- Phoenix, AZ
- NPI 1255820098
-
- Mental Illness Community Based Residential Treatment Facility
- Tolleson, AZ
- NPI 1295323095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583798400000",
"number": "1114552122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9223 W MEADOWBROOK AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850372442",
"telephone_number": "207-409-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9223 W MEADOW BROOK",
"address_2": "9223 W MEADOW BROOK AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850378503",
"telephone_number": "207-409-6515"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANGEL HEART BEHAVIORAL HEALTH III LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-10",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A",
"authorized_official_last_name": "NYIRAKANYANA",
"authorized_official_first_name": "AIMEE",
"authorized_official_title_or_position": "PROGRAM OPERATING OFFICER",
"authorized_official_telephone_number": "623-777-0427"
},
"taxonomies": [
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NO OTHER IDENTIFICATION NUMBER AVAILABLE",
"identifier": "0000",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ANGEL HEART BEHAVIORAL HEALTH III LLC",
"code": "3",
"type": "Doing Business As"
}
]
}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 Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.