Edmond Nyagatare Manzi, LUX SPEI HOMES, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH8008 Issued in AZ

Practice address

2906 W Huntington Dr
Phoenix, AZ 85041-4450

Phone

(602) 394-5954

NPI assigned

May 22, 2023

Last updated

Sep 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lux Spei Homes LLC, Dba

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1740066976

  Community Based Residential Treatment Facility, Mental Illness

  NPD Authorized official

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1588356299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 W HUNTINGTON DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414450",
            "telephone_number": "602-394-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 W HUNTINGTON DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850414450",
            "telephone_number": "602-394-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAGATARE MANZI",
        "first_name": "EDMOND",
        "credential": "LUX SPEI HOMES, LLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH8008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Afam Nwambuonwo
• Esosa Nwambuonwo, FNP-C
• Josiah Nnadozie Nwaokwa
• Sybil Nwulu
• Emma Moraa Nyakundi
• Nicole Nyamongo, MD
• Shanna Nyberg
• Thomas Alex Nyberg, MD
• Taylor Nye

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, 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 Sep 4, 2023; 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.