Centro de Amistad, Incorprorado

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH-187 Issued in AZ

Legal business name

CENTRO DE AMISTAD, INCORPRORADO

Practice address

8202 S Avenida del Yaqui
Guadalupe, AZ 85283-1024

Phone

(480) 839-2926

Fax

(480) 839-9985

NPI assigned

Nov 13, 2006

Last updated

Mar 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Rita Monroy

Title

President and Ceo

Phone

(602) 393-3840

Specialties & licenses 1

Addresses

Other identifiers 5

Tax ID family

Centro de Amistad Incorporado3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Centro de Amistad, Incorporado

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1073684791
  NPD tax ID
• Centro de Amistad, Incorporado

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1467523183
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adimika M Smith, LCSW

  • Clinical Social Worker
  • NPI 1568633667
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1497826101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 N 33RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850175201",
            "telephone_number": "602-393-3840",
            "fax_number": "602-393-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 S AVENIDA DEL YAQUI",
            "city": "GUADALUPE",
            "state": "AZ",
            "postal_code": "852831024",
            "telephone_number": "480-839-2926",
            "fax_number": "480-839-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE AMISTAD, INCORPRORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "MONROY",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "602-393-3840",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS - GRP BILLER",
            "identifier": "125826",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER #",
            "identifier": "105842",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHS VENDOR NO.",
            "identifier": "A000171",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BH LICENSE #",
            "identifier": "BH-187",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS BILLING #",
            "identifier": "1062002",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Kay Anderson, FNP-BC
• Maria E Barnwell, PA
• Juana Barros
• Pamela Jean Beihl, RN BSN
• Erica Carreon, FNP-BC
• Anita Cota
• Jeorgyna Holguin
• Michelle DO Huynh, DO
• Emily Ibarra, RN
• Cheryl Jean Jordan, M.A.

• Community/Behavioral Health Agency in Guadalupe, AZ
• Providers in Guadalupe, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.