HEATHERBRAE HOUSE
NPI 1780122002
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Avondale, AZ

NPI Status: Active since February 07, 2017

Contact Information

12357 W HEATHERBRAE DR
AVONDALE, AZ
ZIP 85392
Phone: (623) 536-9505

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About HEATHERBRAE HOUSE

This page provides the complete NPI Profile along with additional information for Heatherbrae House, a provider established in Avondale, Arizona operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1780122002 assigned on February 2017. The practitioner's primary taxonomy code is 320900000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's other name is Heatherbrae House. The authorized official of this NPI record is Mary A Pank (Paralegal)

NPI
1780122002
Provider Legal Name
RESCARE ARIZONA, INC.
Other Organization Name
HEATHERBRAE HOUSE
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
12357 W HEATHERBRAE DR AVONDALE, AZ 85392
Location Phone
(623) 536-9505
Mailing Address
9901 LINN STATION RD LOUISVILLE, KY 40223
Mailing Phone
(502) 394-2100
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-07-2017
Last Update Date
02-07-2017
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Taxonomy Code
320900000X
Type
Residential Treatment Facilities
Taxonomy Description
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARY A PANK

Authorized Official Title
PARALEGAL
Authorized Official Phone
(502) 420-2666

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1780122002
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2716022400
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 6 + 0 + 2 + 2 + 4 + 0 + 0 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1780122002 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1780122002, enumerated in the NPI registry as an "organization" on February 07, 2017

The provider is located at 12357 W Heatherbrae Dr Avondale, Az 85392 and the phone number is (623) 536-9505

This medical organization specializes in Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X

This NPI record was last updated on February 07, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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