New Casa de Amigas

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

BH 1611 Issued in AZ

Legal business name

NEW CASA DE AMIGAS

Practice address

1648 W Colter St # 8
Phoenix, AZ 85015-3022

Phone

(602) 265-9987

Fax

(602) 265-9983

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Lyle Fox

Title

Executive Director

Phone

(602) 265-9987

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427154368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 W COLTER ST # 8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153022",
            "telephone_number": "602-265-9987",
            "fax_number": "602-265-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 W COLTER ST # 8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153022",
            "telephone_number": "602-265-9987",
            "fax_number": "602-265-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CASA DE AMIGAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-265-9987",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH 1611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.