Healthcare Provider Details

I. General information

NPI: 1851801294
Provider Name (Legal Business Name): BETTER HOMES BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 N 37TH AVE
PHOENIX AZ
85009
US

IV. Provider business mailing address

PO BOX 5044
GOODYEAR AZ
85338-0600
US

V. Phone/Fax

Practice location:
  • Phone: 602-828-5725
  • Fax: 602-269-0832
Mailing address:
  • Phone: 602-828-5725
  • Fax: 602-269-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License NumberOTC8341
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberOTC8341
License Number StateAZ

VIII. Authorized Official

Name: LACRESHIA CASAUNDRA WITCHER
Title or Position: CEO
Credential:
Phone: 602-828-5725