NEW ROOTS RESIDENCY LLC

Address: 3139 W Carson Rd, Phoenix, AZ 85041-6342
Phone: 4802855483

NEW ROOTS RESIDENCY LLC (NPI# 1861024069) 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) 1861024069
Entity Type Organization
Organization Name NEW ROOTS RESIDENCY LLC
Practice Address 3139 W Carson Rd
Phoenix
AZ 85041-6342
Practice Telephone 4802855483
Practice Fax Number 6026751560
Mailing Telephone 4802855483
Mailing Fax Number 6026751560
Enumeration Date 2020-02-06
Last Update Date 2020-02-06
Authorized Official Name PATRICIA WANJA MUTHONI (OWNERADMINISTRATOR)
Authorized Official Telephone 4802855483
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

Office Location

Street Address 3139 W CARSON RD
City PHOENIX
State AZ
Zip Code 85041-6342

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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]

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NPI Name Taxonomy Address Enumeration
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Competitor

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City PHOENIX
Zip Code 85041

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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.