AMEN PERSONAL CAREGIVER — NPI 1609653765 (Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children in ANNA, TX)

CMS-1500 Box 24J / 33a • NPI

1609653765

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

322D00000X

Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children

Box 32 Service Location & ZIP+4

1233 TIANA STREET, ANNA, TX, 75409-1248

✓ 9-Digit EDI 837 ZIP+4 (75409-1248)

Practice Phone & Referral Fax

(401) 282-0856

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1609653765 (AMEN PERSONAL CAREGIVER) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1609653765` (NPI-2 Organization / Facility)
Provider / Legal Name	AMEN PERSONAL CAREGIVER
Plain-English Specialty	Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children NUCC Code: `322D00000X` (Residential Treatment Facility, Emotionally Disturbed Children)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1233 TIANA STREET, ANNA, TX, 75409-1248
Practice Telephone / Fax	Tel: (401) 282-0856
Administrative Mailing Address	1233 TIANA STREET, ANNA, TX, 75409-1248
Enumeration & Last Sync	Enumerated: 2023-09-12 \| CMS Record Updated: 2023-09-12
Authorized Official	SIMON ADEYEMI (Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1233 TIANA STREET, ANNA, TX, 75409-1248

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Plain-English Taxonomy & CMS Crosswalk (322D00000X)

What Does Taxonomy Code 322D00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 322D00000X translates to:
"Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Residential Treatment Facility, Emotionally Disturbed Children for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (AMEN PERSONAL CAREGIVER)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`251E00000X` — Home Health Plain English: CMS-Certified Home Health Care & Skilled Nursing Agency	State: N/A \| License: `Verified` \| Primary: Secondary
`251X00000X` — Supports Brokerage Plain English: Licensed & Credentialed Supports Brokerage	State: N/A \| License: `Verified` \| Primary: Secondary
`322D00000X` — Residential Treatment Facility, Emotionally Disturbed Children Plain English: Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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AMEN PERSONAL CAREGIVER (NPI #1609653765)