Healthcare Provider Details

I. General information

NPI: 1548964026
Provider Name (Legal Business Name): NAVIGATOR BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4638 N 111TH LN
PHOENIX AZ
85037-8333
US

IV. Provider business mailing address

4638 N 111TH LN
PHOENIX AZ
85037-8333
US

V. Phone/Fax

Practice location:
  • Phone: 480-395-0233
  • Fax:
Mailing address:
  • Phone: 480-395-0233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DOMINIC PAIGE
Title or Position: CEO
Credential:
Phone: 480-395-0233