Active NPI
TLR Housing Phoenix LLC
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Phoenix, AZ
National Provider Identifier
1962084137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Legal business name
- TLR HOUSING PHOENIX LLC
- Practice address
- 717 E Palmaire Ave
Phoenix, AZ 85020-5359 - Phone
- (773) 885-3945
- NPI assigned
- Apr 26, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Toni L Richardson
- Title
- Ceo
- Phone
- (773) 885-3945
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | Primary | ||
| Physical Disabilities Residential Treatment Facility | 320700000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | |||
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | |||
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X |
Addresses
Primary practice location
717 E Palmaire Ave
Phoenix, AZ 85020-5359
Mailing address
717 E Palmaire Ave
Phoenix, AZ 85020-5359
Phone (773) 885-3945
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1619395200000",
"number": "1962084137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 E PALMAIRE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850205359",
"telephone_number": "773-885-3945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 E PALMAIRE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850205359",
"telephone_number": "773-885-3945"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TLR HOUSING PHOENIX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-26",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A",
"authorized_official_last_name": "RICHARDSON",
"authorized_official_first_name": "TONI",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "773-885-3945"
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
},
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": null,
"license": null,
"primary": false
},
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Apr 26, 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.