Agnes' Centers for Domestic Solutions

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AGNES' CENTERS FOR DOMESTIC SOLUTIONS

Practice address

455 S 48TH Street
106
Tempe, AZ 85281

Phone

(480) 664-6554

NPI assigned

Feb 15, 2018

Last updated

Feb 15, 2018By 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

Grace Agnes Crockett-Scott

Title

Director

Phone

(480) 664-6554

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Strong House of Healing

  dba Agnes Centers For Domestic Solutions

  • Mental Illness Community Based Residential Treatment Facility
  • Maricopa, AZ
  • NPI 1710518337
  NPPES parent name

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518652800000",
    "number": "1609376698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 S 48TH STREET",
            "address_2": "106",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85281",
            "telephone_number": "480-664-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 S 48TH STREET",
            "address_2": "106",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85281",
            "telephone_number": "480-664-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNES' CENTERS FOR DOMESTIC SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-15",
        "last_updated": "2018-02-15",
        "status": "A",
        "authorized_official_last_name": "CROCKETT-SCOTT",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "AGNES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-664-6554"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Tempe, AZ
• Providers in Tempe, 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 Feb 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.