Assured Dignity Residential Care LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

ASSURED DIGNITY RESIDENTIAL CARE LLC

Practice address

6850 W Carson Rd
Laveen, AZ 85339-7025

Phone

(623) 512-8548

NPI assigned

Mar 25, 2022

Last updated

Mar 25, 2022By 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

Badejoko Odetoye

Title

Owner

Phone

(623) 512-8548

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1225788904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 W CARSON RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397025",
            "telephone_number": "623-512-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 W CARSON RD",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853397025",
            "telephone_number": "623-512-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSURED DIGNITY RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "ODETOYE",
        "authorized_official_first_name": "BADEJOKO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-512-8548"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "princessodetoye@gmail.com",
            "affiliation": "N",
            "address_1": "6850 W Carson Rd",
            "city": "Laveen",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853397025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "princessodetoye@gmail.com",
            "affiliation": "N",
            "address_1": "6850 W Carson Rd",
            "city": "Laveen",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853397025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.