COMMUNITY OF HELPING ANGELS, INC. , NPI 1689668923 — PHOENIX (AZ)

NPI 1689668923

15+ Years Experience Organization

COMMUNITY OF HELPING ANGELS, INC.

09.01.2005
PROVIDER ENUMERATION DATE
07.09.2007
LAST UPDATE DATE
1689668923
NPI NUMBER

About COMMUNITY OF HELPING ANGELS, INC.

COMMUNITY OF HELPING ANGELS, INC. is a provider established in PHOENIX, AZ. The NPI number of COMMUNITY OF HELPING ANGELS, INC. is 1689668923 and was assigned on 09.01.2005. The practitioners primary taxonomy code is: 251E00000X .

Mailing address

  • City: PHOENIX
  • State: AZ
  • Postal code: 850519558
  • Phone: 6025955129
  • Fax: 6029383797
  • Address: 10240 N 31ST AVE
  • Address 2: SU. 114

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1689668923
  • Phone : 6025955129
  • Fax : 6029383797
  • Postalcode : 850519558
  • Address : 10240 N 31ST AVE SU. 114

Additional identifiers

  • Identifier: 711699
  • Code / Type : 5 - MEDICAID
  • Identifier state : AZ

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Home Health

  • Taxonomy code: 251E00000X

The primary taxonomy switch is Not Answered.

Taxonomy description: A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Healthcare provider taxonomy #2 - Homemaker

  • Taxonomy code: 376J00000X
  • License number: UNLICENSED
  • License state: AZ

The primary taxonomy switch is Not Answered.

Taxonomy description: An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.

Contacts:

Click to Show Map
  • COMMUNITY OF HELPING ANGELS, INC.
  • Address : 10240 N 31ST AVE SU. 114
  • Region : PHOENIX, AZ
  • NPI : 1689668923
  • Phone : 6025955129
  • Fax : 6029383797
  • Postalcode : 850519558

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 6024391528
  • Title or position : SECRETARY-TREASURER
  • Credentials : RN

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address10240 N 31ST AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSU. 114
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850519558
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6025955129
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6029383797
The fax number associated with the location address of the provider being identified.
NPI1689668923
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1251E00000X
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Provider Enumeration Date09.01.2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.09.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)COMMUNITY OF HELPING ANGELS, INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address10240 N 31ST AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSU. 114
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NamePHOENIX
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code850519558
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6025955129
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6029383797
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameDODGE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameRICHARD
The first name of the authorized official
Authorized Official Middle NameKINGMAN
The middle name of the authorized official
Authorized Official Title or PositionSECRETARY-TREASURER
The title or position of the authorized official
Authorized Official Credential TextRN
Authorized Official Credential Text
Authorized Official Telephone Number6024391528
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1251E00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Healthcare Provider Primary Taxonomy Switch 1X
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2376J00000X
Healthcare Provider Taxonomy 2Homemaker
An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards.
Provider License Number 2UNLICENSED
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2AZ
Healthcare Provider Primary Taxonomy Switch 2X
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1711699
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1AZ
Other Provider Identifier State #1
X

Share this page?