Healthcare Provider Details

I. General information

NPI: 1578685822
Provider Name (Legal Business Name): NEW HOPE BEHAVIORAL HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 05/06/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S POWER RD 114
MESA AZ
85206-5235
US

IV. Provider business mailing address

215 S POWER RD 114
MESA AZ
85206-5235
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 Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBH2631
License Number StateAZ

VIII. Authorized Official

Name: MINDI A WOODRUFF
Title or Position: ACTING SECRETARY/PROGRAM SPONSOR
Credential: RN
Phone: 480-981-1022