NPIMap

Organization Active NPI

Az Interact LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Glendale, AZ
National Provider Identifier
1427502947
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
BH4514 Issued in AZ
Legal business name
AZ INTERACT LLC
Practice address
6055 West Caribe Lane
Glendale, AZ 85306
Phone
(602) 487-8806
NPI assigned
Aug 12, 2016
Last updated
Aug 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Authorized official

Name
Eduardo Santana
Title
Supervisor
Phone
(602) 487-8806

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X BH4802 AZ
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X BH4801 AZ
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X BH4514 AZ Primary

Addresses

Primary practice location

6055 West Caribe Lane
Glendale, AZ 85306

Mailing address

2325 W Desperado Way
Phoenix, AZ 85085-5777
Phone (602) 487-8806

Other identifiers 3

IdentifierTypeStateIssuer
1518327493MedicaidAZ
1154781037MedicaidAZ
1760885347MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Az Interact LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1470960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470960000000",
    "number": "1427502947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 W DESPERADO WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850855777",
            "telephone_number": "602-487-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 WEST CARIBE LANE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-487-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ INTERACT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A",
        "authorized_official_last_name": "SANTANA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "602-487-8806"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "BH4802",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "BH4801",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "BH4514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518327493",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154781037",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760885347",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.