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General NPI Number Information
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NPI Number | 1962083543
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Entity Type | Organization
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Legal Business Name | MILE HIGH DEVELOPERS LLC
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 13651 N 32ND ST
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City | PHOENIX
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State | AZ
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Zip | 85032-6025
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Country | US
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Telephone | 928-899-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 4643 E KATHLEEN RD
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City | PHOENIX
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State | AZ
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Zip | 85032-4215
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Country | US
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Telephone | 602-354-3692
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOYCE ANN FITZGERALD
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Credential |
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Telephone | 928-899-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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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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