His Mercy Assisted LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

HIS MERCY ASSISTED LLC

Practice address

12362 W Joblanca Rd
Avondale, AZ 85323-3130

Phone

(623) 600-8926

NPI assigned

Jan 4, 2021

Organization subpart

No

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

Authorized official

Name

Ayo Agoro, CEO

Title

Owner

Phone

(623) 600-8926

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• His Mercy Assisted LLC Doing business as

Electronic endpoints 2

Tax ID family

His Mercy Assisted LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• His Mercy Assisted LLC

  • Assisted Living Facility (Behavioral Disturbances)
  • Goodyear, AZ
  • NPI 1124767140
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ayobami Noheem Agoro, CEO

  • Mental Illness Community Based Residential Treatment Facility
  • Avondale, AZ
  • NPI 1649878687

  Community Based Residential Treatment Facility, Mental Illness

  NPD

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1366030561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12362 W JOBLANCA RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853233130",
            "telephone_number": "623-600-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12362 W JOBLANCA RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853233130",
            "telephone_number": "623-600-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIS MERCY ASSISTED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "AGORO",
        "authorized_official_first_name": "AYO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-600-8926",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "BH6411",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "URL",
            "affiliation": "N",
            "endpointDescription": "Desktop and Laptop",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12362 W Joblanca Rd",
            "city": "Avondale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853233130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "URL",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12362 W Joblanca Rd",
            "city": "Avondale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853233130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "His Mercy Assisted LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Sehgal Hinterberger, OTR/L
• Francis Hinton III
• Susannah Hiralez, APRN, PMHNP-BC
• Kayla Roxanne Hironimus
• Braden Christian Hirstein, OD
• HK Kasio LLC
• Phat Dai Hoang, M.D.
• Danielle Hodgkins, PHARMD
• Addison Hofeling
• Jesse Hogan

• Mental Illness Community Based Residential Treatment Facility in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.

Verify at the official NPI Registry.