Provider Demographics
NPI:1285237859
Name:JUDIFY HEALTH SERVICES
Entity type:Organization
Organization Name:JUDIFY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IHEANYI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMANWANNE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCH NP
Authorized Official - Phone:623-206-8074
Mailing Address - Street 1:3880 W RANIER CT
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-8018
Mailing Address - Country:US
Mailing Address - Phone:623-206-8074
Mailing Address - Fax:
Practice Address - Street 1:3880 W RANIER CT
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-8018
Practice Address - Country:US
Practice Address - Phone:602-465-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No283Q00000XHospitalsPsychiatric Hospital
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility