MEDICARE: THE HOPE HOUSE #1.5

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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1194523407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HOPE HOUSE #1.5

Provider Business Mailing Address
First Line	:	28901 N 114TH ST STE 200
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85262-4757
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7287 E EARLL DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7230
Country	:	US
Telephone Number	:	480-448-6142
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	QUINN MCCULLOUGH
Credential	:
Telephone Number	:	480-466-8754

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	04/20/2026

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Directions to “THE HOPE HOUSE #1.5 ” Practice Location

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