NPIMap

Organization Active NPI

Martha's Residential Care LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1275353740
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MARTHA'S RESIDENTIAL CARE LLC
Practice address
4612 N 94TH Dr
Phoenix, AZ 85037-1330
Phone
(480) 217-6996
NPI assigned
Oct 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Saffiatu S Tunis
Title
Program Director
Phone
(480) 217-6996

Specialties & licenses 1

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

Addresses

Primary practice location

4612 N 94TH Dr
Phoenix, AZ 85037-1330

Mailing address

22958 W Pima St
Buckeye, AZ 85326-8734
Phone (480) 217-6996

National Provider Directory

National Provider Directory
Tax ID family
Martha's Residential Care LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1275353740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22958 W PIMA ST",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853268734",
            "telephone_number": "480-217-6996",
            "fax_number": "480-452-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 N 94TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371330",
            "telephone_number": "480-217-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA'S RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "TUNIS",
        "authorized_official_first_name": "SAFFIATU",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "480-217-6996"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.