St Patrick Health Care Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ST PATRICK HEALTH CARE SERVICES

Practice address

1087 W Avalon Canyon Dr
Casa Grande, AZ 85122-6706

Phone

(202) 469-1352

NPI assigned

Jan 6, 2023

Organization subpart

No

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

Authorized official

Name

Patrick Mbah

Title

Owner/Administrator

Phone

(202) 469-1352

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1710691548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 W AVALON CANYON DR",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226706",
            "telephone_number": "202-469-1352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 W AVALON CANYON DR",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226706",
            "telephone_number": "202-469-1352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PATRICK HEALTH CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "MBAH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "202-469-1352"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "address_1": "1087 W Avalon Canyon Dr",
            "city": "Casa Grande",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851226706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.