HUDUMA HOUSE, LLC

Address: 6221 W Illini St, Phoenix, AZ 85043-1915
Phone: 6025169785

HUDUMA HOUSE, LLC (NPI# 1386102788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386102788
Entity Type Organization
Organization Name HUDUMA HOUSE, LLC
Practice Address 6221 W Illini St
Phoenix
AZ 85043-1915
Practice Telephone 6025169785
Mailing Telephone 6025169785
Enumeration Date 2019-03-05
Last Update Date 2019-03-05
Authorized Official Name MR. ROBERT K KOSKEI (HEALTHCARE MANAGER)
Authorized Official Telephone 6025169785
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
AZ ARIZONA DEPARTMENT OF HEALTH SERVICES BH5656 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1851909964 Huduma House, LLC Assisted Living Facility 6218 W Raymond St, Phoenix, AZ 85043 2020-07-15

Office Location

Street Address 6221 W ILLINI ST
City PHOENIX
State AZ
Zip Code 85043-1915

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1265067052 Benchmark Valley LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 7321 S 15th Dr, Phoenix, AZ 85041-6932 2020-03-12
1083249874 Benchmark Valley LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1506 E Irwin Ave, Phoenix, AZ 85042-5618 2020-03-12
1861024069 New Roots Residency LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3139 W Carson Rd, Phoenix, AZ 85041-6342 2020-02-06
1972149078 Serenitybehavioralhealth.llc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 15202 N Flamenco Dr, Phoenix, AZ 85053-4872 2019-11-23
1396158481 Every Voice Counts Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 10610 S 48th St, Unit 1068, Phoenix, AZ 85044-1743 2014-06-05
1902131865 Master Care, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 28809 N 25th Gln, Phoenix, AZ 85085-3737 2009-10-11
1811167067 Arizona Health Care Contract Management Services Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 2208 W Keim Dr, Phoenix, AZ 85015-1943 2008-03-04
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Competitor

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City PHOENIX
Zip Code 85043

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.