WILLIAMS SUDAN GUEST HOMES NPI 1295965531

NPI Information

NPI: 1295965531
Provider Name: WILLIAMS SUDAN GUEST HOMES

Doing Business As: GLENEAGLE RESIDENTIAL CARE & ADULT DAY TREATMENT SERVICES

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
15111 E VIA DE OLIVOS RD
CHANDLER, AZ
ZIP 85249
Phone: (480) 751-7483
Get Directions

WILLIAMS SUDAN GUEST HOMES is a community based residential treatment facility, intellectual and/or developmental disabilities in Chandler, AZ. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. WILLIAMS SUDAN GUEST HOMES NPI is 1295965531. The provider is registered as an organization entity type.
The provider Is Doing Business As Gleneagle Residential Care & Adult Day Treatment Services.

The provider's business location address is:

15111 E VIA DE OLIVOS RD
CHANDLER, AZ
ZIP 85249-423
Phone: (480) 751-7483
Fax: (480) 895-8399

The provider's authorized official is Evelyn Willlliams .
The authorized official title is Clinical Director and has the following contact phone number (480) 751-7483.

The enumeration date for this NPI number is 7/21/2009 and was last updated on 7/21/2009.

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	251C00000X	Day Training, Developmentally Disabled Services		BH-3215	ARIZONA	No
2	251S00000X	Community/Behavioral Health		BH-3215	ARIZONA	No
3	261QM0850X	Clinic/Center	Adult Mental Health	BH-3215	ARIZONA	No
4	261QM2800X	Clinic/Center	Methadone	BBH-3215	ARIZONA	No
5	261QP2000X	Clinic/Center	Physical Therapy	BH-3215	ARIZONA	No
6	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	BH-3215	ARIZONA	No
7	261QX0100X	Clinic/Center	Occupational Medicine	BH-3215	ARIZONA	No
8	320800000X	Community Based Residential Treatment Facility, Mental Illness		BH-3215	ARIZONA	No
9	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	BH-3215	ARIZONA	No
10	347C00000X	Private Vehicle		BH-3215	ARIZONA	No
11	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		BH-3215	ARIZONA	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	438547	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

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