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General NPI Number Information
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NPI Number | 1104667294
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Entity Type | Organization
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Legal Business Name | TOGETHER BHRF
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 10423 W EDGEMONT DR
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City | AVONDALE
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State | AZ
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Zip | 85392-4652
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Country | US
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Telephone | 480-358-7850
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Fax |
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Provider Business Mailing Address
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Address Line | 10423 W EDGEMONT DR
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City | AVONDALE
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State | AZ
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Zip | 85392-4652
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Country | US
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Telephone | 480-358-7850
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOJOK AJAWIN
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Credential |
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Telephone | 480-358-7850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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