Active NPI
Bianca McKinney
- Mental Illness Community Based Residential Treatment Facility
- Laveen, AZ
National Provider Identifier
1144903311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Practice address
- 4622 W Fremont Rd
Laveen, AZ 85339-4277 - Phone
- (480) 335-4134
- NPI assigned
- Aug 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary |
Addresses
Primary practice location
4622 W Fremont Rd
Laveen, AZ 85339-4277
Mailing address
4622 W Fremont Rd
Laveen, AZ 85339-4277
Phone (480) 335-4134
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1144903311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4622 W FREMONT RD",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853394277",
"telephone_number": "480-335-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4622 W FREMONT RD",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853394277",
"telephone_number": "480-335-4134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKINNEY",
"first_name": "BIANCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-14",
"last_updated": "2023-08-14",
"certification_date": "2023-08-13",
"status": "A"
},
"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 Laveen, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.