New Roots Residency LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Phoenix, AZ
NPI 1861024069 · NPPES record last updated Feb 6, 2020
Key facts
- NPI
- 1861024069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- NEW ROOTS RESIDENCY LLC
- Practice address
- 3139 W Carson Rd
Phoenix, AZ 85041-6342 - Phone
- (480) 285-5483
- Fax
- (602) 675-1560
- NPI assigned
- Feb 6, 2020
- Organization subpart
- No
Authorized official
- Name
- Patricia Wanja Muthoni
- Title
- Owneradministrator
- Phone
- (480) 285-5483
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
3139 W Carson Rd
Phoenix, AZ 85041-6342
Mailing address
3139 W Carson Rd
Phoenix, AZ 85041-6342
Phone (480) 285-5483
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.