HUDUMA HOUSE LLC NPI 1386102788

NPI Information

NPI: 1386102788
Provider Name: HUDUMA HOUSE, LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
6221 W ILLINI ST
PHOENIX, AZ
ZIP 85043
Phone: (602) 516-9785
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HUDUMA HOUSE, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Phoenix, 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. HUDUMA HOUSE, LLC NPI is 1386102788. The provider is registered as an organization entity type.

The provider's business location address is:

6221 W ILLINI ST
PHOENIX, AZ
ZIP 85043-915
Phone: (602) 516-9785

The provider's authorized official is Robert K Koskei .
The authorized official title is Healthcare Manager and has the following contact phone number (602) 516-9785.

The enumeration date for this NPI number is 3/5/2019 and was last updated on 3/5/2019.

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	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				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	BH5656	OTHER	ARIZONA	ARIZONA DEPARTMENT OF HEALTH SERVICES

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: 11/14/2023

NPI Synchronization or Removal

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