Healthcare Provider Details

I. General information

NPI: 1063105534
Provider Name (Legal Business Name): NORTHSTAR BEHAVORIAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14050 N NORTHSIGHT BLVD
SCOTTSDALE AZ
85260-3930
US

IV. Provider business mailing address

1934 E CAMELBACK RD # 462
PHOENIX AZ
85016-4126
US

V. Phone/Fax

Practice location:
  • Phone: 480-500-8065
  • Fax:
Mailing address:
  • Phone: 480-500-8065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PARIS RASHEED
Title or Position: ADMINISTRATOR
Credential:
Phone: 480-500-8065