EUREKA IMPERIAL RESIDENCE 3
NPI: 1679092506
· GILBERT, AZ 85295
· Mental Illness Community Based Residential Treatment Facility
· NPI assigned 09/12/2017
$135K
Total Medicaid Paid
Provider Details
| Authorized Official | TANYI, CORNELIUS (PROGRAM DIRECTOR) |
| Parent Organization | EUREKA IMPERIAL RESIDENCE |
| NPI Enumeration Date | 09/12/2017 |
Related Entities
Other providers sharing the same authorized official: TANYI, CORNELIUS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
16 |
$40K |
| 2022 |
476 |
$91K |
| 2023 |
692 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
1,184 |
370 |
$135K |