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General NPI Number Information
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NPI Number | 1073209318
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Entity Type | Organization
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Legal Business Name | DREAM LAND MENTAL HEALTH
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 1300 S LITCHFIELD RD
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City | GOODYEAR
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State | AZ
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Zip | 85338-1513
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Country | US
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Telephone | 602-529-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 16365 W BADEN AVE
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City | GOODYEAR
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State | AZ
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Zip | 85338-6269
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Country | US
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Telephone | 602-529-0706
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAMZA PAULSON
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Credential |
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Telephone | 602-592-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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