New Roots Residency LLC

Primary specialty

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

Last updated

Feb 6, 2020By 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

Patricia Wanja Muthoni

Title

Owneradministrator

Phone

(480) 285-5483

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1861024069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3139 W CARSON RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416342",
            "telephone_number": "480-285-5483",
            "fax_number": "602-675-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3139 W CARSON RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416342",
            "telephone_number": "480-285-5483",
            "fax_number": "602-675-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ROOTS RESIDENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "MUTHONI",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "WANJA",
        "authorized_official_title_or_position": "OWNERADMINISTRATOR",
        "authorized_official_telephone_number": "480-285-5483"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Phoenix, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.