Residential Grouphome Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RESIDENTIAL GROUPHOME SERVICES LLC

Practice address

6102 S 37TH LN
Phoenix, AZ 85041-5021

Phone

(602) 718-8809

NPI assigned

Aug 4, 2022

Organization subpart

No

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

Authorized official

Name

Robert McNeal, BSNPI 1770921785

Title

Owner /Operator

Phone

(602) 718-8809

Specialties & licenses 3

Addresses

Other identifiers 4

Practitioners 1

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

• Robert McNeal

  • Social Worker
  • Phoenix, AZ
  • NPI 1770921785
  NPD Authorized official

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1649907148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 E ALTA VISTA RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850424551",
            "telephone_number": "602-718-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 S 37TH LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415021",
            "telephone_number": "602-718-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL GROUPHOME SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-04",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "MCNEAL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER /OPERATOR",
        "authorized_official_telephone_number": "602-718-8809",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103TC0700X",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103TA0400X",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103TC1900X",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103TP2701X",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, 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 Oct 5, 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.