Organization · NPI-2

Az Peace Of Mind Behavioral Health Home LLC

Assisted Living Facility, Assisted Living, Mental Illness · Surprise, AZ

NPI number1821616319

StatusActive

Last updated in NPPESJul 10, 2020

Details

NPI: 1821616319
Entity type: Organization (NPI-2)
Legal business name: Az Peace Of Mind Behavioral Health Home LLC
Organization subpart: No
Enumeration date: Jul 10, 2020
Certification date: Jul 10, 2020
Last updated: Jul 10, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
3104A0625X	Assisted Living Facility, Assisted Living, Mental Illness	–	–	Yes
276400000X	Rehabilitation, Substance Use Disorder Unit	–	–
3104A0630X	Assisted Living Facility, Assisted Living, Behavioral Disturbances	–	–
320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	–
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–

Practice location

15622 W Sierra St
Surprise, AZ 85379-1038

Phone 623-214-6420

Mailing address

15622 W Sierra St
Surprise, AZ 85379-1038

Authorized official

Elvine Muteteri
Administrator
6232146420

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.