Family Care Behavioral Home LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

FAMILY CARE BEHAVIORAL HOME LLC

Practice address

7357 W Valencia Dr
Laveen, AZ 85339-3469

Phone

(623) 800-9688

NPI assigned

Aug 18, 2021

Last updated

Aug 18, 2021By 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

Geraldine Goodall

Title

Ceo

Phone

(623) 800-9688

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1952077158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7357 W VALENCIA DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853393469",
            "telephone_number": "623-800-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7357 W VALENCIA DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853393469",
            "telephone_number": "623-800-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE BEHAVIORAL HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "GOODALL",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-800-9688"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "BH6801",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BUSINESS",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "BUSINESS EMAIL",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "BUSINESS EMAIL",
            "address_1": "7357 W Valencia Dr",
            "city": "Laveen",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853393469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.