Healthcare Provider Details

I. General information

NPI: 1285261891
Provider Name (Legal Business Name): HOPE & HEALING ADDICTION TREATMENT CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 E LONE CACTUS DR
PHOENIX AZ
85024-5507
US

IV. Provider business mailing address

67 S HIGLEY RD STE 103-208
GILBERT AZ
85296-1166
US

V. Phone/Fax

Practice location:
  • Phone: 602-900-5557
  • Fax: 602-374-3197
Mailing address:
  • Phone: 480-868-8697
  • Fax: 906-374-3197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA FORTSON
Title or Position: MANAGING MEMBER
Credential:
Phone: 480-868-8697