Good Samaritan Group Home LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

GOOD SAMARITAN GROUP HOME LLC

Practice address

12332 W San Juan Ave
Litchfield Park, AZ 85340-3445

Phone

(480) 300-1698

NPI assigned

May 17, 2023

Last updated

May 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Billy Bijende

Title

President

Phone

(480) 300-1698

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1205527579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12332 W SAN JUAN AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403445",
            "telephone_number": "480-300-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12332 W SAN JUAN AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403445",
            "telephone_number": "480-300-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "BIJENDE",
        "authorized_official_first_name": "BILLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-300-1698"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Walter Glodek, M.D.
• Gisele Hailey Gomez, RBT
• Lauren Nicole Gonzales, MS, BCBA, LBA
• Jessica Gonzalez, BA, RBT
• Nyomi Gonzalez, RBT
• Pat Goodrich, SLP
• Goodyear ABA Therapy LLC
• Kristen Graham, FNP-BC
• Grateful and Beyond Assisted Living LLC
• Beth Ann Graupe, NP

• Mental Illness Community Based Residential Treatment Facility in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.