NPIMap

Organization Active NPI

Imani Residential Treatment Home

  • Mental Illness Community Based Residential Treatment Facility
  • Beaverton, OR
National Provider Identifier
1417898941
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
IMANI RESIDENTIAL TREATMENT HOME
Practice address
14325 SW Wilson Dr
Beaverton, OR 97008-6140
Phone
(971) 357-1234
NPI assigned
Apr 1, 2026
Organization subpart
Yes
Parent organization
IMANI MENTAL HEALTH AND WELLNESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Authorized official

Name
Ms. Susan Mbugua, PMHNP-BCNPI 1932503539
Title
Adminstrator
Phone
(214) 458-1713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

14325 SW Wilson Dr
Beaverton, OR 97008-6140

Mailing address

14325 SW Wilson Dr
Beaverton, OR 97008-6140
Phone (971) 357-1234

Other names 1

  • IMANI RESIDENTIAL TREATMENT HOME Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imani Mental HLTH and Well2 organizations share this tax ID, including this one
Part of
Imani Mental HLTH and Well

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1417898941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14325 SW WILSON DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086140",
            "telephone_number": "971-357-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14325 SW WILSON DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970086140",
            "telephone_number": "971-357-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMANI RESIDENTIAL TREATMENT HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMANI MENTAL HEALTH AND WELLNESS LLC",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "MBUGUA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "214-458-1713",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMANI RESIDENTIAL TREATMENT HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.