Active NPI
Huduma House, LLC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Phoenix, AZ
National Provider Identifier
1386102788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- HUDUMA HOUSE, LLC
- Practice address
- 6221 W Illini St
Phoenix, AZ 85043-1915 - Phone
- (602) 516-9785
- NPI assigned
- Mar 5, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert K Koskei
- Title
- Healthcare Manager
- Phone
- (602) 516-9785
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
6221 W Illini St
Phoenix, AZ 85043-1915
Mailing address
6221 W Illini St
Phoenix, AZ 85043-1915
Phone (602) 516-9785
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BH5656 | Other | AZ | ARIZONA DEPARTMENT OF HEALTH SERVICES |
National Provider Directory
National Provider Directory- Tax ID family
- Huduma House LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Addiction (Substance Use Disorder) Counselor
- Phoenix, AZ
- NPI 1184334641
-
- Assisted Living Facility (Behavioral Disturbances)
- Phoenix, AZ
- NPI 1851909964
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Behavior Technician
- Phoenix, AZ
- NPI 1073151171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1551744000000",
"number": "1386102788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6221 W ILLINI ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850431915",
"telephone_number": "602-516-9785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6221 W ILLINI ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850431915",
"telephone_number": "602-516-9785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUDUMA HOUSE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-05",
"status": "A",
"authorized_official_last_name": "KOSKEI",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "HEALTHCARE MANAGER",
"authorized_official_telephone_number": "602-516-9785",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA DEPARTMENT OF HEALTH SERVICES",
"identifier": "BH5656",
"state": "AZ"
}
],
"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 Mar 5, 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.