Organization Active NPI

Heart to Heart Behavioral Health Group Home, LLC

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1336602788
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HEART TO HEART BEHAVIORAL HEALTH GROUP HOME, LLC
Practice address
8535 W Palm LN
Phoenix, AZ 85037-3902
Phone
(480) 977-9457
NPI assigned
Apr 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Usman J Bundu, RN, MSN/PH
Title
Program Director
Phone
(480) 977-9457

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

8535 W Palm LN
Phoenix, AZ 85037-3902

Mailing address

3555 N Sailboat LN
Avondale, AZ 85392-3620
Phone (480) 977-9457

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1336602788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 N SAILBOAT LN",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853923620",
            "telephone_number": "480-977-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 W PALM LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373902",
            "telephone_number": "480-977-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART TO HEART BEHAVIORAL HEALTH GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "BUNDU",
        "authorized_official_first_name": "USMAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "480-977-9457",
        "authorized_official_credential": "RN, MSN/PH"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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 Apr 12, 2019; 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.