Organization
GOOD SAMARITAN RESIDENTIAL CARE LLC
Active
Organization
GOOD SAMARITAN RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIDIER TWAGIRAYEZU (ADMINISTRATOR)
(817) 480-3474
Entity
Organization
Contact information
Practice address
1536 E INOUYE DR, CASA GRANDE, AZ 85122-6590
(817) 480-3474
Mailing address
1536 E INOUYE DR, CASA GRANDE, AZ 85122-6590
(817) 480-3474
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH7786
AZDHS
AZ
Enumeration date
07/22/2022
Last updated
07/22/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up