Active NPI
Trinity Recovery Home LLC
- Mental Illness Community Based Residential Treatment Facility
- Surprise, AZ
National Provider Identifier
1326899444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Legal business name
- TRINITY RECOVERY HOME LLC
- Doing business as
- Serenity Villa
- Practice address
- 17622 W Port Royale LN
Surprise, AZ 85388-7792 - Phone
- (602) 837-6800
- Fax
- (602) 837-6868
- NPI assigned
- Mar 27, 2024
- Organization subpart
- Yes
- Parent organization
- TRINITY RECOVERY HOME LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sydney Davis
- Title
- Manager
- Phone
- (602) 387-6800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary |
Addresses
Primary practice location
17622 W Port Royale LN
Surprise, AZ 85388-7792
Mailing address
4374 N 153Rd Dr
Goodyear, AZ 85395-8392
Phone (602) 837-6800
Other names 1
- Serenity Villa
National Provider Directory
National Provider Directory- Tax ID family
- Trinity Recovery Home LLC
- Part of
- Trinity Recovery Home LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Illness Community Based Residential Treatment Facility
- Litchfield Park, AZ
- NPI 1619728730
-
- Psychiatric Residential Treatment Facility
- Glendale, AZ
- NPI 1942172119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1711497600000",
"number": "1326899444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4374 N 153RD DR",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853958392",
"telephone_number": "602-837-6800",
"fax_number": "602-837-6868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17622 W PORT ROYALE LN",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853887792",
"telephone_number": "602-837-6800",
"fax_number": "602-837-6868"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRINITY RECOVERY HOME LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRINITY RECOVERY HOME LLC",
"enumeration_date": "2024-03-27",
"last_updated": "2024-03-27",
"certification_date": "2024-03-27",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "SYDNEY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "602-387-6800"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Serenity Villa",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Surprise, AZ
- Denise A Trichilo, MA, LAC
- Tricity Express Care PLLC
- Stephanie L Trimino, DPT
- Trinity Group Homes
- Trinity Group Homes, Inc
- Taylor Beth Trout
- Matthew Trovato
- True Care Physical Therapy and Rehabilitation, PLLC
- Truecomfort Home Care Solutions of Montana LLC
- Truecomfort Home Care Solutions of New Mexico LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.