Mulligan'S Manor

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

MULLIGAN'S MANOR

Practice address

4701 S. Lakeshore Drive # 1
Tempe, AZ 85282

Phone

(480) 455-2601

NPI assigned

Jun 4, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer Diaz, MSW, LCSWNPI 1952515215

Title

Executive Director

Phone

(480) 455-2601

Specialties & licenses 1

Addresses

Tax ID family

Mulligan'S Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mulligan'S Manor, Inc.

  • Mental Health Counselor
  • Tempe, AZ
  • NPI 1427536770
  NPD tax ID

Locations

Practitioners 1

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

• Jennifer Diaz, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1952515215
  NPD Authorized official

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174903173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 S LAKESHORE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827169",
            "telephone_number": "480-831-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 S. LAKESHORE DRIVE # 1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-455-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULLIGAN'S MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-455-2601",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Michelle Mueller, PA-C
• Pearl Janepher Mugisha
• Jennifer Ann Muhammad, DNP, FNP-C, PMHNP-BC
• Deena Muhammedali
• Mulberry Medical LLC
• Mulligan'S Manor, Inc.
• Rebecca Mullins, M.A. CCC - SLP
• Elizabeth Mullnix, ATC
• Multispecialty Group of Flagstaff
• Magimvuyu N Mumbere, NP

• Foster Care Agency in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Foster Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.