NPIMap

Organization Active NPI

Sovereign Health of Phoenix, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Chandler, AZ
National Provider Identifier
1174950471
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
2005211229 Issued in DE
Legal business name
SOVEREIGN HEALTH OF PHOENIX, INC.
Practice address
111 S Hearthstone Way
Chandler, AZ 85226-5010
Phone
(949) 625-0376
Fax
(949) 390-9899
NPI assigned
Oct 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Authorized official

Name
Mr. Ron Girskis
Title
Business Operations Specialist
Phone
(949) 359-8273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 2005211229 DE Primary

Addresses

Primary practice location

111 S Hearthstone Way
Chandler, AZ 85226-5010

Mailing address

PO Box 5705
San Clemente, CA 92674-5705
Phone (949) 625-0376

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1174950471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5705",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926745705",
            "telephone_number": "949-625-0376",
            "fax_number": "949-390-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S HEARTHSTONE WAY",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265010",
            "telephone_number": "949-625-0376",
            "fax_number": "949-390-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTH OF PHOENIX, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "GIRSKIS",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS SPECIALIST",
        "authorized_official_telephone_number": "949-359-8273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "DE",
            "license": "2005211229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.