Healthcare Provider Details
I. General information
NPI: 1083087134
Provider Name (Legal Business Name): BETTER HOMES BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/10/2015
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4324 E FRIESS DR
PHOENIX AZ
85032-5802
US
IV. Provider business mailing address
10425 W COLTER ST
GLENDALE AZ
85307-4194
US
V. Phone/Fax
- Phone: 602-790-8487
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | BH4899 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | BH4899 |
| License Number State | AZ |
VIII. Authorized Official
Name: MR.
STERLING
BRIDGES
Title or Position: PRESIDENT
Credential:
Phone: 602-790-8487