Healthcare Provider Details

I. General information

NPI: 1578335527
Provider Name (Legal Business Name): JAMES HINTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 12/31/2023
Certification Date: 12/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N 1ST ST STE 7180
PHOENIX AZ
85004-2357
US

IV. Provider business mailing address

7800 N 55TH AVE STE 102
GLENDALE AZ
85301-1322
US

V. Phone/Fax

Practice location:
  • Phone: 480-442-5439
  • Fax:
Mailing address:
  • Phone: 623-294-4554
  • Fax: 623-401-6659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: JAMES HINTON
Title or Position: COO
Credential:
Phone: 623-294-4554