Healthcare Provider Details

I. General information

NPI: 1427910785
Provider Name (Legal Business Name): MAIDEN VOYAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14188 W HOPE DR
SURPRISE AZ
85379-4344
US

IV. Provider business mailing address

6599 N ORACLE RD STE B
TUCSON AZ
85704-5614
US

V. Phone/Fax

Practice location:
  • Phone: 520-614-8647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAWNA BECKMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 520-614-8647