NPIMap

Organization Active NPI

Az Comfort Home, Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Surprise, AZ
National Provider Identifier
1811554074
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
AZ COMFORT HOME, INC
Doing business as
Cottonwood House
Practice address
16439 W Cottonwood St
Surprise, AZ 85388-2160
Phone
(623) 666-3895
Fax
(623) 321-1206
NPI assigned
May 23, 2019
Organization subpart
Yes
Parent organization
AZ COMFORT HOME, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Authorized official

Name
John Omijie
Title
Program Director
Phone
(623) 326-3327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

16439 W Cottonwood St
Surprise, AZ 85388-2160

Mailing address

18412 W Mission LN
Waddell, AZ 85355-4303
Phone (623) 326-3327

Other names 1

  • Cottonwood House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Az Comfort Home Inc2 organizations share this tax ID, including this one
Part of
Az Comfort Home Inc

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1811554074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18412 W MISSION LN",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853554303",
            "telephone_number": "623-326-3327",
            "fax_number": "623-321-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16439 W COTTONWOOD ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853882160",
            "telephone_number": "623-666-3895",
            "fax_number": "623-321-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ COMFORT HOME, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AZ COMFORT HOME, INC",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "OMIJIE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "623-326-3327"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottonwood House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.