Russell Appleton

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH7438 Issued in AZ

Practice address

1121 N Olive Ave
Casa Grande, AZ 85122-3418

Phone

(602) 618-3756

NPI assigned

May 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Olive Branch Assisted Living LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Casa Grande, AZ
  • NPI 1245963610

  Psychiatric Residential Treatment Facility

  NPD Authorized official
• Olive Branch Assisted Living LLC

  • Non-emergency Medical Transport (VAN)
  • Casa Grande, AZ
  • NPI 1801394861
  NPD Authorized official
• Terra Medical of Arizona LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Casa Grande, AZ
  • NPI 1649014077

  Community Based Residential Treatment Facility, Mental Illness

  NPD Authorized official

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1386380996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 E WHITE ASTER ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444908",
            "telephone_number": "602-618-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 N OLIVE AVE",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851223418",
            "telephone_number": "602-618-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPLETON",
        "first_name": "RUSSELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-06",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "BH7438",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "BH7438",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "BH7438",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": "BH7438",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": "BH7438",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH7438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS - LICENSE FOR BHRF",
            "identifier": "BH7438",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cleanstart.life",
            "affiliation": "N",
            "endpointDescription": "web portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1121 N Olive Ave",
            "city": "Casa Grande",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851223418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bose Grace Anifowose, DNP, FNP, PMHNP
• Robert Cristian Anthis, HAD
• Apex Mobile Imaging LLC
• Katherine Appel
• Paul Appleby, LISAC
• Archimedes Marcelo Aquino, L.P.C.
• Rustom Araia, PHARMD
• Carlos Eduardo Arce-Lara, M.D.
• Frances Archuleta
• Arizona Behavioral Health Center PC

• Mental Illness Community Based Residential Treatment Facility in Casa Grande, AZ
• Providers in Casa Grande, 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 Jun 19, 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.

Verify at the official NPI Registry.