Active NPI
Gift of Hearts Home III, LLC
Doing business as Gift of hearts home
- Mental Illness Community Based Residential Treatment Facility
- Phoenix, AZ
National Provider Identifier
1295308708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Legal business name
- GIFT OF HEARTS HOME III, LLC
- Doing business as
- Gift of hearts home
- Practice address
- 2529 N 88TH LN
Phoenix, AZ 85037-3412 - Phone
- (480) 466-3852
- NPI assigned
- Jul 22, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michel Gahakanyi
- Title
- Chief Executive Officer
- Phone
- (605) 413-0143
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary |
Addresses
Primary practice location
2529 N 88TH LN
Phoenix, AZ 85037-3412
Mailing address
2529 N 88TH LN
Phoenix, AZ 85037-3412
Phone (480) 466-3852
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH6900 | Medicaid | AZ |
Other names 1
- Gift of hearts home
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | tolleson | Direct |
National Provider Directory
National Provider Directory- Tax ID family
- Gift of Hearts Home
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Counselor
- Tolleson, AZ
- NPI 1134704240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626912000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1626912000000",
"number": "1295308708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2529 N 88TH LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373412",
"telephone_number": "480-466-3852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2529 N 88TH LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373412",
"telephone_number": "480-466-3852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GIFT OF HEARTS HOME III, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-22",
"last_updated": "2021-07-22",
"certification_date": "2021-07-22",
"status": "A",
"authorized_official_last_name": "GAHAKANYI",
"authorized_official_first_name": "MICHEL",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "605-413-0143"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "BH6900",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "tolleson",
"affiliation": "N",
"endpointDescription": "tolleson",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2529 N 88th Ln",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850373412",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Gift of hearts home",
"code": "3",
"type": "Doing Business As"
}
]
}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 Jul 22, 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.