Jca Afc Homes

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

JCA AFC HOMES

Practice address

8674 S 165TH Ave
Goodyear, AZ 85338-1447

Phone

(602) 731-1883

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Dominique GistNPI 1629674742

Title

Owner

Phone

(313) 434-6821

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dominique L Gist

  • Psychiatric Residential Treatment Facility
  • Goodyear, AZ
  • NPI 1629674742
  NPD Authorized official

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1154916245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11213 W IVORY LN",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853923916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8674 S 165TH AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381447",
            "telephone_number": "602-731-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCA AFC HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "GIST",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-434-6821"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manav Jasrotia, MD
• Kiranmai Jasti, DO
• Ramon Jauregui, MD
• Java Autism Services LLC
• Jay S. Suaverdez DDS PLLC
• Penny M Jefferson, RN
• Patrick Jennings, PT, DPT
• David Laurtiz Jensen, D.O.
• Samuel Jensen
• Jerome a Cohn DPM PC

• Psychiatric Residential Treatment Facility in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Psychiatric Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.