NPIMap

Organization Active NPI

JRW Residential Services LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1922526045
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH5262 Issued in AZ
Legal business name
JRW RESIDENTIAL SERVICES LLC
Practice address
2428 W Sagebrush Dr
Phoenix, AZ 85085-5026
Phone
(623) 234-8818
Fax
(623) 242-1096
NPI assigned
Sep 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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

Authorized official

Name
Mr. Aaron Alexander Wright
Title
Managing Partner/Asst.Administrator
Phone
(623) 210-4872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH5262 AZ Primary

Addresses

Primary practice location

2428 W Sagebrush Dr
Phoenix, AZ 85085-5026

Mailing address

3906 W Darrow St
Phoenix, AZ 85041-6010
Phone (623) 210-4872

Other names 1

  • DreamLife Residential Homes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dreamlife Residential Homes3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1922526045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 W DARROW ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416010",
            "telephone_number": "623-210-4872",
            "fax_number": "623-242-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 W SAGEBRUSH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850855026",
            "telephone_number": "623-234-8818",
            "fax_number": "623-242-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRW RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "MANAGING PARTNER/ASST.ADMINISTRATOR",
        "authorized_official_telephone_number": "623-210-4872",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH5262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DreamLife Residential Homes",
            "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 Sep 8, 2017; 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.