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NPI Code Detail

MEDICARE: BOE

MEDICARE: BOE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1144898156
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOE
Provider Business Mailing Address
First Line : 6751 N SUNSET BLVD STE 320
Second Line :
City : GLENDALE
State : AZ
Zip : 85305-3155
Country : US
Telephone Number : 602-529-2393
Fax Number :
Provider Business Practice Location Address
First Line : 6751 N SUNSET BLVD STE 320
Second Line :
City : GLENDALE
State : AZ
Zip : 85305-3155
Country : US
Telephone Number : 602-529-2393
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : CARMEN GUSTIN
Credential :
Telephone Number : 602-434-1289
Provider Enumeration Date : 06/15/2021
Last Update Date : 12/23/2025

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Directions to “BOE ” Practice Location

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