Trinity Recovery Home LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

TRINITY RECOVERY HOME LLC

Practice address

4374 N 153Rd Dr
Goodyear, AZ 85395-8392

Phone

(623) 295-2323

NPI assigned

Jul 8, 2021

Organization subpart

Yes

Parent organization

TRINITY RECOVERY HOME LLCAs reported in NPPES

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

Authorized official

Name

Sydney Davis

Title

Surrogate

Phone

(602) 837-6800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Guest House Recovery Home Doing business as

Part of

Trinity Recovery Home LLC

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705190400000",
    "number": "1639740723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4374 N 153RD DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958392",
            "telephone_number": "623-295-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4374 N 153RD DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958392",
            "telephone_number": "623-295-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13218 W Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Litchfield Park",
            "state": "AZ",
            "postal_code": "853409552",
            "country_code": "US",
            "telephone_number": "602-837-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRINITY RECOVERY HOME LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY RECOVERY HOME LLC",
        "enumeration_date": "2021-07-08",
        "last_updated": "2024-01-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SYDNEY",
        "authorized_official_title_or_position": "SURROGATE",
        "authorized_official_telephone_number": "602-837-6800"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85-1549738",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guest House Recovery Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric Residential Treatment Facility in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Psychiatric Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2024; 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.