JUSSAMAL MANOR 11 – NPI #1770931966
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.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

JUSSAMAL MANOR 11 is a community based residential treatment facility located in CHANDLER, AZ. NPPES has assigned the NPI number 1770931966 to JUSSAMAL MANOR 11 on May 27, 2016. 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 JUSSAMAL MANOR 11 below.

NPI Profile for
JUSSAMAL MANOR 11

NPI Number
1770931966
Enumeration Date

(more than 10 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
JUSSAMAL MANOR 11
Primary location
641 S. KAREN DR.
CHANDLER, AZ 85224
Phone: (480) 621-8640 Fax: (480) 257-3447
Mailing address
Same as primary location
Organization Subpart
Yes - JUSSAMAL MANOR 11 is subpart of another organization.
Authorized Official
SAMUEL MARIRA
CEO./PROGRAM DIRECTOR
Phone: (480) 570-6245
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 BH4726

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.