Healthcare Provider Details

I. General information

NPI: 1790020303
Provider Name (Legal Business Name): ASCEND BEHAVIORAL HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35005 N 27TH LN
PHOENIX AZ
85086-6663
US

IV. Provider business mailing address

27818 N 24TH LN
PHOENIX AZ
85085-4706
US

V. Phone/Fax

Practice location:
  • Phone: 623-879-9522
  • Fax:
Mailing address:
  • Phone: 602-460-1449
  • Fax:

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: ROBERTA ABDALLAH
Title or Position: CEO
Credential:
Phone: 602-460-1449