Provider Demographics
NPI:1114265972
Name:HELPING HEARTS RESIDENTIAL FACILITIES I, LLC
Entity Type:Organization
Organization Name:HELPING HEARTS RESIDENTIAL FACILITIES I, LLC
Other - Org Name:HELPING HEARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YNEZ
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:602-622-1290
Mailing Address - Street 1:1500 E THOMAS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5748
Mailing Address - Country:US
Mailing Address - Phone:602-622-1290
Mailing Address - Fax:602-926-1491
Practice Address - Street 1:6129 W INDIANOLA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-4138
Practice Address - Country:US
Practice Address - Phone:623-846-4293
Practice Address - Fax:602-926-1491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH4135320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness