Healthcare Provider Details

I. General information

NPI: 1164711750
Provider Name (Legal Business Name): SINGLETON HOUSING,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8102 N 23RD AVE SUITE B
PHOENIX AZ
85021-4962
US

IV. Provider business mailing address

8102 N 23RD AVE SUITE B
PHOENIX AZ
85021-4962
US

V. Phone/Fax

Practice location:
  • Phone: 602-626-8150
  • Fax: 602-626-8406
Mailing address:
  • Phone: 602-626-8150
  • Fax: 602-626-8406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberBH3830
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberBH3830
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number3830
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberBH3830
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberBH3830
License Number StateAZ

VIII. Authorized Official

Name: MS. ELIZABETH SINGLETON
Title or Position: ADMIN
Credential:
Phone: 602-626-8150