EUREKA IMPERIAL RESIDENCE – NPI #1679704381
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

EUREKA IMPERIAL RESIDENCE is a community based residential treatment facility located in GILBERT, AZ. NPPES has assigned the NPI number 1679704381 to EUREKA IMPERIAL RESIDENCE on July 29, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

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 EUREKA IMPERIAL RESIDENCE below.

NPI Profile for
EUREKA IMPERIAL RESIDENCE

NPI Number
1679704381
Enumeration Date

(about 17 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
EUREKA IMPERIAL RESIDENCE
Primary location
1740 S HERITAGE DRIVE
GILBERT, AZ 85296
Phone: (480) 264-2647 Fax: (480) 264-2647
Mailing address
7110 S CHAMPAGNE WAY
GILBERT, AZ 85298-9122
Phone: (480) 375-5192 Fax: (480) 821-7860
Organization Subpart
No
Authorized Official
CORNELIUS TANYI
EXECUTIVE DIRECTOR
Phone: (480) 375-5192
Updated
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
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
AZ BH3319

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.