Shining Hearts Residential Treatment Center LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

SHINING HEARTS RESIDENTIAL TREATMENT CENTER LLC

Doing business as

Shining Hearts Residential Treatment Center

Practice address

21352 N Denton Dr
Maricopa, AZ 85138-9559

Phone

(469) 401-8195

NPI assigned

Oct 19, 2021

Organization subpart

No

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

Authorized official

Name

Jada Alexander

Title

President

Phone

(469) 401-8195

Specialties & licenses 4

Addresses

Other names 1

• Shining Hearts Residential Treatment Center Doing business as

Electronic endpoints 1

Tax ID family

Quadra Behavioral Health2 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.

• Quadra Behavioral Health LLC

  dba Quadra Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chandler, AZ
  • NPI 1184490641
  NPD tax ID

Locations

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1205599016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44920 W HATHAWAY AVE UNIT 658",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851399937",
            "telephone_number": "469-401-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21352 N DENTON DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851389559",
            "telephone_number": "469-401-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING HEARTS RESIDENTIAL TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JADA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-401-8195"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "referral.2.shllc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "44920 W Hathaway Ave Unit 658",
            "city": "Maricopa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851399937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shining Hearts Residential Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mason Shaw, PT, DPT
• Theresa Shibilski
• Shielded Pathways LLC
• Linda Susan Shields, M.A.
• Shining Hearts (Shining Hearts Residential Treatment Center)
• Joanne Lynn Siebert, D.C.
• Katherine Siebert, DC
• Michael Simon Jr.
• Anthony Sinagra, RADT1
• Rachel Singer, M.D

• Emotionally Disturbed Childrens' Residential Treatment Facility in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Arizona

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