Healthcare Provider Details

I. General information

NPI: 1992387112
Provider Name (Legal Business Name): NEW HOPE BEHAVIORAL HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S POWER RD STE 216
MESA AZ
85206-5238
US

IV. Provider business mailing address

215 S POWER RD STE 114
MESA AZ
85206-5236
US

V. Phone/Fax

Practice location:
  • Phone: 480-981-1022
  • Fax: 480-981-1405
Mailing address:
  • Phone: 480-981-1022
  • Fax: 480-981-1405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MINDI A WOODRUFF
Title or Position: OWNER
Credential:
Phone: 480-981-1022