NPIMap

Organization Active NPI

Saguaro Foundation Community Living Programs

  • Mental Illness Community Based Residential Treatment Facility
  • Yuma, AZ
National Provider Identifier
1962896738
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH4508 Issued in AZ
Legal business name
SAGUARO FOUNDATION COMMUNITY LIVING PROGRAMS
Practice address
2620 S 16TH Dr
Yuma, AZ 85364-7055
Phone
(928) 344-1618
Fax
(928) 782-0061
NPI assigned
Mar 19, 2015
Last updated
Apr 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Authorized official

Name
Mr. Michael Kerry Van Guilder, M.S.
Title
Executive Director
Phone
(928) 783-6069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH4508 AZ Primary

Addresses

Primary practice location

2620 S 16TH Dr
Yuma, AZ 85364-7055

Mailing address

1495 S 4TH Ave
Yuma, AZ 85364-4603
Phone (928) 783-6069

National Provider Directory

National Provider Directory
Tax ID family
Saguaro Foundation Community Living Programs7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1962896738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 S 4TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644603",
            "telephone_number": "928-783-6069",
            "fax_number": "928-782-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S 16TH DR",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647055",
            "telephone_number": "928-344-1618",
            "fax_number": "928-782-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGUARO FOUNDATION COMMUNITY LIVING PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "VAN GUILDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KERRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "928-783-6069",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH4508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.