Phoenix Gospel Mission, Inc. Dba Phoenix Rescue Mission

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX GOSPEL MISSION, INC. DBA PHOENIX RESCUE MISSION

Practice address

338 N 15TH Ave
Phoenix, AZ 85007-2402

Phone

(602) 475-1695

NPI assigned

Dec 18, 2020

Organization subpart

No

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

Authorized official

Name

Nathan Smith

Title

Chief Program Officer

Phone

(602) 419-8194

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Rescue Mission Doing business as

Tax ID family

Phoenix Gospel Mission Inc Dba Phoenix Rescue Mission2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Phoenix Gospel Mission, Inc. Dba Phoenix Rescue Mission

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1811497670
  NPD tax ID

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1740876242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 W VAN BUREN ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850072414",
            "telephone_number": "602-475-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 N 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850072402",
            "telephone_number": "602-475-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX GOSPEL MISSION, INC. DBA PHOENIX RESCUE MISSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CHIEF PROGRAM OFFICER",
        "authorized_official_telephone_number": "602-419-8194"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Rescue Mission",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix Rescue Mission",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Feeding Therapy, PLLC
• Phoenix First Assist LLC
• Phoenix First Assists LLC
• Phoenix Foot & Ankle Associates PC
• Phoenix Gi Associates PC
• Phoenix Gospel Mission, Inc. Dba Phoenix Rescue Mission
• Phoenix Head and Neck Surgery LTD
• Phoenix Health & Wellness Center Inc.
• Phoenix Health Practitioners LLC
• Phoenix Health Psychology, PLLC

• 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 17, 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.