NPIMap

Organization Active NPI

Arizona Behavioral Care Homes LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Goodyear, AZ
National Provider Identifier
1528360898
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH-3724 Issued in AZ
Legal business name
ARIZONA BEHAVIORAL CARE HOMES LLC
Practice address
16575 W Roosevelt St
Goodyear, AZ 85338-6192
Phone
(623) 594-9064
Fax
(623) 925-9876
NPI assigned
Nov 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Robert Crawford Breedlove, LMSW
Title
Ceo
Phone
(480) 840-1601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH-3724 AZ Primary

Addresses

Primary practice location

16575 W Roosevelt St
Goodyear, AZ 85338-6192

Mailing address

4645 S Lakeshore Dr Ste 3
Tempe, AZ 85282-7152
Phone (480) 840-1601

National Provider Directory

National Provider Directory
Tax ID family
Arizona Behavioral Care Homes LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1528360898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 S LAKESHORE DR STE 3",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827152",
            "telephone_number": "480-840-1601",
            "fax_number": "480-840-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16575 W ROOSEVELT ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853386192",
            "telephone_number": "623-594-9064",
            "fax_number": "623-925-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA BEHAVIORAL CARE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-18",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "BREEDLOVE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CRAWFORD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-840-1601",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH-3724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.