Bougainvillea Manor LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

BOUGAINVILLEA MANOR LLC

Doing business as

Bougainvillea Manor 2344
Bougainvillea Manor Behavioral Health

Practice address

2344 W Apollo Rd
Phoenix, AZ 85041-5333

Phone

(480) 239-9648

NPI assigned

May 29, 2023

Last updated

May 17, 2026By 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. Krishna P Ashili

Title

Administrator

Phone

(480) 239-9648

Specialties & licenses 1

Addresses

Other names 2

• BOUGAINVILLEA MANOR 2344 Doing business as
• Bougainvillea Manor Behavioral Health Doing business as

Tax ID family

Bougainvillea Manor 23442 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.

• Bougainvillea Manor LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Laveen, AZ
  • NPI 1477396661
  NPD tax ID

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778976000000",
    "number": "1811680713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 W APOLLO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415333",
            "telephone_number": "480-239-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2344 W APOLLO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415333",
            "telephone_number": "480-239-9648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6646 S 57th Ave",
            "address_purpose": "LOCATION",
            "city": "Laveen",
            "state": "AZ",
            "postal_code": "853392254",
            "country_code": "US",
            "telephone_number": "480-239-9648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6638 S 57th Ave",
            "address_purpose": "LOCATION",
            "city": "Laveen",
            "state": "AZ",
            "postal_code": "853392254",
            "country_code": "US",
            "telephone_number": "480-239-9648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOUGAINVILLEA MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-29",
        "last_updated": "2026-05-17",
        "certification_date": "2026-05-17",
        "status": "A",
        "authorized_official_last_name": "ASHILI",
        "authorized_official_first_name": "KRISHNA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-239-9648",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOUGAINVILLEA MANOR 2344",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bougainvillea Manor Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Nicole Boucos
• Farzin Brian Boudi, M.D.
• Shadi May Boudreau, LPC
• Tailyr Marnae Boudreaux, MS CCC-SLP
• Crystal Bouey, CRNA
• Michael Bougoulias, MD
• Boukus Inc (Arcadia Health and Wellness Chiropractic)
• Frederick Thornton Boulware, M.D.
• Paul Christopher Boulware, M.D.
• Paige E Bouma

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2026; 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.