PHA RESIDENTIAL LLC; NPI #1396597753

Contact Information

PHA RESIDENTIAL LLC

5312 W STARGAZER PL
LAVEEN VILLAGE, AZ 85339-4512

Phone: 602-502-6238
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Community Based Residential Treatment Facility, Mental Illness	320800000X
Adult Mental Health	261QM0850X
Case Management	251B00000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X
Community/Behavioral Health	251S00000X
Counselor	101Y00000X
Health Service	261QH0100X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Psychiatric Residential Treatment Facility	323P00000X
Public Health or Welfare	251K00000X	60	Public Health or Welfare Agency
Registered Nurse	163W00000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X
Substance Abuse Disorder Rehabilitation Facility	324500000X
Substance Abuse Treatment, Children	3245S0500X

Indicates primary specialty

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NPI Profile & details for PHA RESIDENTIAL LLC

NPI Number	`1396597753`
LBN Legal business name	PHA RESIDENTIAL LLC
Authorized official	PHALINA MITCHELL - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	04/01/2024
Last updated	04/02/2024 - About 2 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PHA RESIDENTIAL LLC

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NPI Profile & details for PHA RESIDENTIAL LLC

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