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General NPI Number Information
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NPI Number | 1366155277
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Entity Type | Organization
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Legal Business Name | ACTIVE HEALING PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 3126 S HIGLEY RD STE 104
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City | GILBERT
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State | AZ
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Zip | 85295-2030
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Country | US
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Telephone | 520-346-0831
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Fax | 520-422-5545
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Provider Business Mailing Address
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Address Line | 1600 W CHANDLER BLVD STE 100
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City | CHANDLER
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State | AZ
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Zip | 85224-6100
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Country | US
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Telephone | 480-719-7400
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Fax | 480-719-7400
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Authorized Official
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Title or Position | OWNER
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Name | MICHAELA BEAVER
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Credential | DNP, ARNP
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Telephone | 480-719-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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