Healthcare Provider Details

I. General information

NPI: 1134960800
Provider Name (Legal Business Name): ORION HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3907 W MORROW DR
GLENDALE AZ
85308-7532
US

IV. Provider business mailing address

16605 N 28TH AVE STE 101
PHOENIX AZ
85053-7551
US

V. Phone/Fax

Practice location:
  • Phone: 602-466-3223
  • Fax:
Mailing address:
  • Phone: 602-466-3223
  • Fax: 602-441-3981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRANDON DOW
Title or Position: CEO
Credential:
Phone: 602-466-3223