NPIMap

Organization Active NPI

Benedicta House

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1891558946
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BENEDICTA HOUSE
Doing business as
Benedicta House
Practice address
3349 E Cambridge Ave
Phoenix, AZ 85008-1215
Phone
(602) 477-9416
NPI assigned
Feb 1, 2024
Last updated
Feb 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SHALOM BEHAVIORAL HOUSE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Authorized official

Name
Aime Mukura Linda Minega Shabani, BHT
Title
Administrator
Phone
(602) 477-9416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3349 E Cambridge Ave
Phoenix, AZ 85008-1215

Mailing address

11063 W Virginia Ave
Avondale, AZ 85392-5889
Phone (602) 477-9416

Other names 1

  • BENEDICTA HOUSE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shalom Behavioral House LLC3 organizations share this tax ID, including this one
Part of
Shalom Behavioral House LLC

Other organizations with this tax ID 2

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": "1706745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706745600000",
    "number": "1891558946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11063 W VIRGINIA AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925889",
            "telephone_number": "602-477-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 E CAMBRIDGE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850081215",
            "telephone_number": "602-477-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEDICTA HOUSE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHALOM BEHAVIORAL HOUSE, LLC",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A",
        "authorized_official_last_name": "MINEGA SHABANI",
        "authorized_official_first_name": "AIME",
        "authorized_official_middle_name": "MUKURA LINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-477-9416",
        "authorized_official_credential": "BHT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BENEDICTA HOUSE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.