Az Families Co-Op LLC

Primary specialty

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

Legal business name

AZ FAMILIES CO-OP LLC

Practice address

4391 East Marshall CT
Gilbert, AZ 85297

Phone

(855) 755-2932

Fax

(855) 755-2932

NPI assigned

Mar 18, 2022

Last updated

Mar 18, 2022By 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

Mr. Rex Roger Matthews

Title

Partner

Phone

(855) 755-2932

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1801545850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 E BROADWAY BLVD # 286",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113704",
            "telephone_number": "855-755-2932",
            "fax_number": "855-755-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4391 EAST MARSHALL CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85297",
            "telephone_number": "855-755-2932",
            "fax_number": "855-755-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ FAMILIES CO-OP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "855-755-2932",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS NUMBER",
            "identifier": "429547",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF DEVELOPMENTAL DISABILITIES DDD",
            "identifier": "Q07201813808",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.