Active NPI
Kelechi Onwuchekwa
- Mental Illness Community Based Residential Treatment Facility
- Phoenix, AZ
National Provider Identifier
1306442678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Practice address
- 9005 W Vernon Ave
Phoenix, AZ 85037-3637 - Phone
- (602) 472-0105
- NPI assigned
- Dec 10, 2020
- Last updated
- Jan 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Residential Treatment Facility | 323P00000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary |
Addresses
Primary practice location
9005 W Vernon Ave
Phoenix, AZ 85037-3637
Mailing address
12228 W Pima St
Avondale, AZ 85323-8105
Phone (602) 472-0105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliance Health Services LLC | Community Based Residential Treatment Facility, Mental Illness | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Illness Community Based Residential Treatment Facility
- Phoenix, AZ
- NPI 1740866888
Community Based Residential Treatment Facility, Mental Illness
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672963200000",
"number": "1306442678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12228 W PIMA ST",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853238105",
"telephone_number": "602-472-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9005 W VERNON AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373637",
"telephone_number": "602-472-0105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ONWUCHEKWA",
"first_name": "KELECHI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-10",
"last_updated": "2023-01-06",
"certification_date": "2023-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": null,
"license": null,
"primary": false
},
{
"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 Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.