Healthcare Provider Details

I. General information

NPI: 1033662549
Provider Name (Legal Business Name): TOUCH ANGELS BEHAVIOR HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5045 S TATUM LN
GILBERT AZ
85298-0511
US

IV. Provider business mailing address

5045 S TATUM LN
GILBERT AZ
85298-0511
US

V. Phone/Fax

Practice location:
  • Phone: 480-616-0133
  • Fax: 480-616-0133
Mailing address:
  • Phone: 480-616-0133
  • Fax: 480-616-0133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberBH4923
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SAMUEL OWUSU-AKYEAW
Title or Position: ADMINISTRATOR
Credential:
Phone: 425-350-9818