NPIMap

Organization Active NPI

Arizona Homes of Miracles LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1710553086
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
ARIZONA HOMES OF MIRACLES LLC
Practice address
2534 W Saint Catherine Ave
Phoenix, AZ 85041-5354
Phone
(602) 358-8165
NPI assigned
May 27, 2021
Last updated
May 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA HOMES OF MIRACLES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Abdisaak Mohamud
Title
Owner
Phone
(612) 306-0639

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

2534 W Saint Catherine Ave
Phoenix, AZ 85041-5354

Mailing address

3205 S 63Rd LN
Phoenix, AZ 85043-1958

National Provider Directory

National Provider Directory
Tax ID family
Arizona Homes of Miracles LLC2 organizations share this tax ID, including this one
Part of
Arizona Homes of Miracles LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1710553086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 S 63RD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 W SAINT CATHERINE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415354",
            "telephone_number": "602-358-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA HOMES OF MIRACLES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA HOMES OF MIRACLES, LLC",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "MOHAMUD",
        "authorized_official_first_name": "ABDISAAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-306-0639"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.