NPIMap

Organization Active NPI

Tri-Phase Group Home Inc

  • Counselor
  • Gilbert, AZ
National Provider Identifier
1396914735
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
BH-1914 Issued in AZ
Legal business name
TRI-PHASE GROUP HOME INC
Practice address
1575 E Betsy LN Unit D
Gilbert, AZ 85296-3759
Phone
(623) 474-6326
Fax
(623) 474-6516
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Mrs. Sherri McKinney
Title
Director
Phone
(623) 474-6326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X BH-1914 AZ Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X BH-1914 AZ

Addresses

Primary practice location

1575 E Betsy LN Unit D
Gilbert, AZ 85296-3759

Mailing address

18403 W Verdin Rd
Goodyear, AZ 85338-5081
Phone (623) 474-6326

Other identifiers 1

IdentifierTypeStateIssuer
873770OtherAZAHCCCS

National Provider Directory

National Provider Directory
Tax ID family
Tri-Phase Group Home Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1396914735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18403 W VERDIN RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853385081",
            "telephone_number": "623-474-6326",
            "fax_number": "623-474-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 E BETSY LN UNIT D",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963759",
            "telephone_number": "623-474-6326",
            "fax_number": "623-474-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-PHASE GROUP HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "623-474-6326",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "AZ",
            "license": "BH-1914",
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "AZ",
            "license": "BH-1914",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "873770",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.