NPIMap

Organization Active NPI

Adora Healthcare Services

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1972195428
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
ADORA HEALTHCARE SERVICES
Practice address
3045 E Cholla St
Phoenix, AZ 85028-1917
Phone
(216) 544-5418
Fax
(623) 251-7452
NPI assigned
Feb 5, 2021
Organization subpart
Yes
Parent organization
ADORA HEALTHCARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Authorized official

Name
Peter Tamunoh Teboh, FNP-BC
Title
Ceo
Phone
(216) 544-5418

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

3045 E Cholla St
Phoenix, AZ 85028-1917

Mailing address

3045 E Cholla St
Phoenix, AZ 85028-1917
Phone (216) 544-5418

Other identifiers 1

IdentifierTypeStateIssuer
520776MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Adora Healthcare Services2 organizations share this tax ID, including this one
Part of
Adora Healthcare Services

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1972195428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 E CHOLLA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281917",
            "telephone_number": "216-544-5418",
            "fax_number": "623-251-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 E CHOLLA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281917",
            "telephone_number": "216-544-5418",
            "fax_number": "623-251-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADORA HEALTHCARE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADORA HEALTHCARE SERVICES",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "TEBOH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "TAMUNOH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-544-5418",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "520776",
            "state": "AZ"
        }
    ],
    "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 Feb 5, 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.