PRESIDENTIAL MANSIONCARE, LLC – NPI #1437532991
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

PRESIDENTIAL MANSIONCARE, LLC is a residential treatment facility located in GOODYEAR, AZ. NPPES has assigned the NPI number 1437532991 to PRESIDENTIAL MANSIONCARE, LLC on July 02, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320600000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 2 years ago on Dec 11, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PRESIDENTIAL MANSIONCARE, LLC below.

NPI Profile for
PRESIDENTIAL MANSIONCARE, LLC

NPI Number
1437532991
Enumeration Date

(about 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRESIDENTIAL MANSIONCARE, LLC
Primary location
18428 W MIAMI ST
GOODYEAR, AZ 85338-7490
Phone: (623) 202-9583 Fax: (623) 882-0715
Mailing address
1647 S 170TH AVE
GOODYEAR, AZ 85338-7324
Phone: (623) 202-9583 Fax: (623) 215-2212
Organization Subpart
No
Authorized Official
KENNEDY AMUGHAN
EXECUTIVE DIRECTOR
Phone: (623) 202-9583
Updated
Certification Date
Dec 11, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
AZ BH2753

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.