NPIMap

Organization Active NPI

Faith Behavioral Health Group, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1801395876
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH5359 Issued in AZ
Legal business name
FAITH BEHAVIORAL HEALTH GROUP, LLC
Doing business as
Faith Behavioral Health Group LLC
Practice address
3101 W Larkspur Dr
Phoenix, AZ 85029-2331
Phone
(602) 368-7178
NPI assigned
Feb 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
Mr. Mary KiiluNPI 1811310808
Title
Registered Nurse
Phone
(909) 441-9520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH5359 AZ Primary

Addresses

Primary practice location

3101 W Larkspur Dr
Phoenix, AZ 85029-2331

Mailing address

3101 W Larkspur Dr
Phoenix, AZ 85029-2331
Phone (602) 368-7178

Other identifiers 1

IdentifierTypeStateIssuer
BH5359OtherAZARIZONA STATE LICENSE

Other names 1

  • FAITH BEHAVIORAL HEALTH GROUP LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Faith Behavioral Health Group LLC2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1801395876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 W LARKSPUR DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292331",
            "telephone_number": "602-368-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W LARKSPUR DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292331",
            "telephone_number": "602-368-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH BEHAVIORAL HEALTH GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "KIILU",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "909-441-9520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH5359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE LICENSE",
            "identifier": "BH5359",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAITH BEHAVIORAL HEALTH GROUP LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 30, 2020; 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.