Christian Care Surprise, Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

CHRISTIAN CARE SURPRISE, INC.

Doing business as

Fellowship Square Outpatient Rehabilitation

Practice address

16640 N Sarival Rd
Surprise, AZ 85388-2202

Phone

(623) 300-9401

Fax

(623) 432-0276

NPI assigned

Oct 5, 2022

Last updated

Oct 5, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

CHRISTIAN CARE SURPRISE, INC.As reported in NPPES

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

Authorized official

Name

Jami F Gross

Title

Executive Director

Phone

(623) 300-9401

Specialties & licenses 1

Addresses

Other names 1

• Fellowship Square Outpatient Rehabilitation Doing business as

Electronic endpoints 1

Part of

Christian Care Surprise Inc

Locations

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1245955913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16477 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853746603",
            "telephone_number": "623-300-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16640 N SARIVAL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853882202",
            "telephone_number": "623-300-9401",
            "fax_number": "623-432-0276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11830 N 19th Ave Apt 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850293520",
            "country_code": "US",
            "telephone_number": "602-443-5400",
            "fax_number": "602-443-5449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6945 E Main St",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852078206",
            "country_code": "US",
            "telephone_number": "888-460-2182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8111 E Broadway Blvd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857103937",
            "country_code": "US",
            "telephone_number": "833-944-1673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 W Brown Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852013428",
            "country_code": "US",
            "telephone_number": "480-290-7019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTIAN CARE SURPRISE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIAN CARE SURPRISE, INC.",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "JAMI",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "623-300-9401"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "christiancare.org",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16640 N Sarival Rd",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853882202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Fellowship Square Outpatient Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Choose to Change
• Raushni Chopra, LPC
• Chosen Behavioral Home, LLC (Chosen Behavioral Home)
• Chrisol Care Home
• Janae Christensen
• Christian Family Care
• Angela Christian, LPC
• Audrey Leigh Christians, M.S., CCC-SLP
• Sheryl Mlapaz Chua, FNP-C
• Eunmee P Chung, DNP

• Rehabilitation Clinic/Center in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Rehabilitation Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.