Miss a'S LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH5029 Issued in AZ

Legal business name

MISS A'S LLC

Practice address

8606 N 68TH LN
Peoria, AZ 85345-8451

Phone

(623) 234-2475

Fax

(623) 234-2475

NPI assigned

Dec 19, 2016

Organization subpart

No

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

Authorized official

Name

Allisa Deneke

Title

Administrator

Phone

(623) 670-0039

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Miss a'S LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Miss a'S LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Peoria, AZ
  • NPI 1851926166
  NPD tax ID

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1447795992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 W DESERT HILLS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042703",
            "telephone_number": "623-670-0039",
            "fax_number": "623-234-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8606 N 68TH LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458451",
            "telephone_number": "623-234-2475",
            "fax_number": "623-234-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISS A'S LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-19",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "DENEKE",
        "authorized_official_first_name": "ALLISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "623-670-0039"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH5029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222757",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindful Heart Center LLC
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• Cheryl Lynn Minear
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• Diana Miranda
• Miss a'S LLC
• Missing Pieces.Org
• Jessica Mitchell, OTR/L
• Tiffany Nicole Mitchell, N.M.D.
• Ronald Joseph Mittel Jr., M.D.

• Mental Illness Community Based Residential Treatment Facility in Peoria, AZ
• Providers in Peoria, 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 Apr 5, 2017; 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.