Nevaeh's LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

BH-3374 Issued in AZ

Legal business name

NEVAEH'S LLC

Practice address

403 W Harwell Rd
Phoenix, AZ 85041-8034

Phone

(602) 441-3050

NPI assigned

Oct 9, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Dee'Anna Marie Smallwood

Title

Chief Administion Officer

Phone

(602) 413-4412

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255046400000",
    "number": "1174858088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W HARWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850418034",
            "telephone_number": "602-441-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W HARWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850418034",
            "telephone_number": "602-441-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVAEH'S LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2009-10-09",
        "status": "A",
        "authorized_official_last_name": "SMALLWOOD",
        "authorized_official_first_name": "DEE'ANNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF ADMINISTION OFFICER",
        "authorized_official_telephone_number": "602-413-4412",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH-3374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2009; 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.