Healthcare Provider Details

I. General information

NPI: 1790064152
Provider Name (Legal Business Name): BETTER HORIZONS BEHAVIOARAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2184 E. FIRESTONE DR
CHANDLER AZ
85249
US

IV. Provider business mailing address

2184 E. FIRESTONE DR
CHANDLER AZ
85249
US

V. Phone/Fax

Practice location:
  • Phone: 480-634-4974
  • Fax:
Mailing address:
  • Phone: 480-634-4974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberBH3876
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberBH3876
License Number StateAZ

VIII. Authorized Official

Name: MRS. CLARISSE YOLLANDE KUISSU
Title or Position: ADMINISTRATOR
Credential:
Phone: 602-400-7764