Terra Medical of Arizona LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

TERRA MEDICAL OF ARIZONA LLC

Doing business as

House of Hope Behavioral Health LLC

Practice address

1297 E Avenida Kino
Casa Grande, AZ 85122-1011

Phone

(520) 709-1586

Fax

(602) 235-0405

NPI assigned

Jun 20, 2024

Organization subpart

No

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

Authorized official

Name

Russell AppletonNPI 1386380996

Title

Manager

Phone

(602) 618-3756

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• House of Hope Behavioral Health LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell Appleton

  • Mental Illness Community Based Residential Treatment Facility
  • Casa Grande, AZ
  • NPI 1386380996

  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": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1649014077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N POTTEBAUM RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225326",
            "telephone_number": "602-618-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 E AVENIDA KINO",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221011",
            "telephone_number": "520-709-1586",
            "fax_number": "602-235-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 E 11th St",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851223609",
            "country_code": "US",
            "telephone_number": "602-618-3756",
            "fax_number": "602-235-0405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 N Pottebaum Rd",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851225326",
            "country_code": "US",
            "telephone_number": "602-618-3756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1121 N Olive Ave",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851223418",
            "country_code": "US",
            "telephone_number": "520-709-1586",
            "fax_number": "602-235-0405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TERRA MEDICAL OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "APPLETON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-618-3756"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "BH10111",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "BH6760",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "BH10112",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "House of Hope Behavioral Health LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Illness Community Based Residential Treatment Facility in Casa Grande, AZ
• Providers in Casa Grande, 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 Jun 20, 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.