Dajusha Incorporation

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH2952 Issued in AZ

Legal business name

DAJUSHA INCORPORATION

Practice address

4815 W Crittenden LN
Phoenix, AZ 85031-3145

Phone

(623) 846-0420

Fax

(623) 247-0968

NPI assigned

Nov 10, 2007

Organization subpart

No

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

Authorized official

Name

Brigitt Lynn Young

Title

Ceo

Phone

(623) 846-0420

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1194652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194652800000",
    "number": "1891975553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5698",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853125698",
            "telephone_number": "623-846-0420",
            "fax_number": "623-247-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 W CRITTENDEN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850313145",
            "telephone_number": "623-846-0420",
            "fax_number": "623-247-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAJUSHA INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-10",
        "last_updated": "2007-11-10",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "BRIGITT",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-846-0420"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH2952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Nov 10, 2007; 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.