Grace House Behavioral Health Agency Level 3

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH-3475 Issued in AZ

Legal business name

GRACE HOUSE BEHAVIORAL HEALTH AGENCY LEVEL 3

Practice address

2733 W Michigan Ave
Phoenix, AZ 85053-1734

Phone

(623) 583-8086

NPI assigned

Jan 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Saul Wasswa

Title

Owner/Administrator

Phone

(623) 583-8086

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1407186737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 W MICHIGAN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850531734",
            "telephone_number": "623-583-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2733 W MICHIGAN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850531734",
            "telephone_number": "623-583-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOUSE BEHAVIORAL HEALTH AGENCY LEVEL 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "WASSWA",
        "authorized_official_first_name": "SAUL",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "623-583-8086",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Clinical Counseling Centre, Inc
• Grace Family Care LLC
• Grace Health Sytems LLC
• Grace Home Care Arizona
• Grace Home Care Arizona LLC
• Grace Kalt Counseling PLLC
• Grace Medical Supply LLC
• Grace of Serenity Living
• Grace of Serenity Living
• Grace of Serenity Living, Inc

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, 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 8, 2010; 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.