THE HERITAGE BEHAVIORAL HEALTH HOME LLC NPI 1114536752

NPI Information

NPI: 1114536752
Provider Name: THE HERITAGE BEHAVIORAL HEALTH HOME LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
3927 W ROVEY AVE
PHOENIX, AZ
ZIP 85019
Phone: (602) 675-3975
Get Directions

THE HERITAGE BEHAVIORAL HEALTH HOME LLC is a community based residential treatment facility mental illness in Phoenix, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. THE HERITAGE BEHAVIORAL HEALTH HOME LLC NPI is 1114536752. The provider is registered as an organization entity type.

The provider's business location address is:

3927 W ROVEY AVE
PHOENIX, AZ
ZIP 85019-633
Phone: (602) 675-3975

The provider's authorized official is Kristen Smith .
The authorized official title is Director Of Operations and has the following contact phone number (973) 270-4676.

The enumeration date for this NPI number is 7/29/2020 and was last updated on 8/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3104A0630X	Assisted Living Facility	Assisted Living, Behavioral Disturbances			No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00000000	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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