NPIMap

Organization Active NPI

Avra Valley Reliance Behavioral Home LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1194311449
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
AVRA VALLEY RELIANCE BEHAVIORAL HOME LLC
Practice address
2010 W Grant Rd
Tucson, AZ 85745-1108
Phone
(520) 622-0488
Fax
(520) 622-0487
NPI assigned
Dec 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Catherine Kamwithi, BSN, RNNPI 1952997462
Title
Manager/Owner
Phone
(978) 729-2869

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2010 W Grant Rd
Tucson, AZ 85745-1108

Mailing address

2162 W Speedway Blvd Apt 31104
Tucson, AZ 85745-3938
Phone (978) 729-2869

Other names 1

  • Avra Valley Reliance Behavioral Home LLC Other name

National Provider Directory

National Provider Directory
Tax ID family
Avra Valley Reliance Behavioral Home LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1194311449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2162 W SPEEDWAY BLVD APT 31104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857453938",
            "telephone_number": "978-729-2869",
            "fax_number": "520-622-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451108",
            "telephone_number": "520-622-0488",
            "fax_number": "520-622-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVRA VALLEY RELIANCE BEHAVIORAL HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-21",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "KAMWITHI",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "978-729-2869",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avra Valley Reliance Behavioral Home LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.