Provider Demographics
NPI:1912697111
Name:HEART OF FRIENDS LIVING HOMES LLC
Entity Type:Organization
Organization Name:HEART OF FRIENDS LIVING HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSYOKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-621-9894
Mailing Address - Street 1:4758 E TIERRA BUENA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3361
Mailing Address - Country:US
Mailing Address - Phone:480-621-9894
Mailing Address - Fax:
Practice Address - Street 1:2736 E WIER AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2748
Practice Address - Country:US
Practice Address - Phone:623-281-5723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle