NPIMap

Organization Active NPI

Home Away From Home Behavioral Health Residential Facility Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Peoria, AZ
National Provider Identifier
1790166072
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
BH4584 Issued in AZ
Legal business name
HOME AWAY FROM HOME BEHAVIORAL HEALTH RESIDENTIAL FACILITY INC.
Doing business as
Home Away From Home Behavioral Health Residential
Practice address
9231 W Mountain View Rd
Peoria, AZ 85345-4306
Phone
(602) 559-6033
Fax
(623) 322-8622
NPI assigned
Jun 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Authorized official

Name
Mrs. Tanya Marguerite Ayiyi, LPN
Title
Ceo
Phone
(602) 559-6033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X BH4584 AZ Primary

Addresses

Primary practice location

9231 W Mountain View Rd
Peoria, AZ 85345-4306

Mailing address

PO Box 7077
Goodyear, AZ 85338-0635
Phone (602) 559-6033

Other names 1

  • Home Away From Home Behavioral Health Residential Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Home Away From Home Behavioral Health Residential2 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.

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434067200000",
    "number": "1790166072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7077",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853380635",
            "telephone_number": "602-559-6033",
            "fax_number": "623-322-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9231 W MOUNTAIN VIEW RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853454306",
            "telephone_number": "602-559-6033",
            "fax_number": "623-322-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME AWAY FROM HOME BEHAVIORAL HEALTH RESIDENTIAL FACILITY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A",
        "authorized_official_last_name": "AYIYI",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "MARGUERITE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-559-6033",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "AZ",
            "license": "BH4584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Away From Home Behavioral Health Residential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.