Ecclisia House Behavioral Health

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH - 3050 Issued in AZ

Legal business name

ECCLISIA HOUSE BEHAVIORAL HEALTH

Practice address

831 E Greenway Rd
Phoenix, AZ 85042-5545

Phone

(602) 441-2691

NPI assigned

Jun 19, 2008

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elizabeth Singleton

Title

Administrator

Phone

(602) 441-2691

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1750542965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 E GREENWAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 E GREENWAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425545",
            "telephone_number": "602-441-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECCLISIA HOUSE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-441-2691"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH - 3050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.