Immune Centered Health

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

IMMUNE CENTERED HEALTH

Practice address

23157 N 103Rd LN
Peoria, AZ 85383-2753

Phone

(623) 440-4838

NPI assigned

May 22, 2023

Organization subpart

No

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

Authorized official

Name

Andrea Kidawski

Title

Owner

Phone

(561) 302-7706

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1336831296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5146",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330745146",
            "telephone_number": "561-302-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23157 N 103RD LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832753",
            "telephone_number": "623-440-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNE CENTERED HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-20",
        "status": "A",
        "authorized_official_last_name": "KIDAWSKI",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-302-7706"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Rehabilitation PLLC
• Ignite Hormone and Wellness
• Marianne Illustre
• Immanuel Behavioral Health Counseling Clinic
• Immanuel Caring Ministries, Inc.
• Impact Health Services LLC
• Impact Physical Therapy LLC
• Anca O Incean
• Incite Health and Wellness, LLC
• Infinite Peace Hospice LLC

• Assisted Living Facility (Behavioral Disturbances) in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Assisted Living Facility (Behavioral Disturbances) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.