Active NPI
Muco Behavioral Health Residential Home, LLC
- Community/Behavioral Health Agency
- Avondale, AZ
National Provider Identifier
1659157147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME, LLC
- Practice address
- 12413 W Monroe St
Avondale, AZ 85323-8002 - Phone
- (623) 600-8283
- NPI assigned
- Aug 31, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deogratias Baransaka, MA
- Title
- Administrator
- Phone
- (623) 760-8378
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
12413 W Monroe St
Avondale, AZ 85323-8002
Mailing address
12413 W Monroe St
Avondale, AZ 85323-8002
Phone (623) 600-8384
Other names 1
- Muco Home 3
National Provider Directory
National Provider Directory- Tax ID family
- Muco Behavioral Health Residential Home LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Peoria, AZ
- NPI 1275942468
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Peoria, AZ
- NPI 1598090151
Community/Behavioral Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693440000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729036800000",
"number": "1659157147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12413 W MONROE ST",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853238002",
"telephone_number": "623-600-8384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12413 W MONROE ST",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853238002",
"telephone_number": "623-600-8283"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MUCO BEHAVIORAL HEALTH RESIDENTIAL HOME, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-31",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A",
"authorized_official_last_name": "BARANSAKA",
"authorized_official_first_name": "DEOGRATIAS",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "623-760-8378",
"authorized_official_credential": "MA"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Muco Home 3",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Muco Home 3",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.