MEDICARE: ARIZONA'S NEW HOPE, PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356805816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA'S NEW HOPE, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 129
Second Line	:
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-0129
Country	:	US
Telephone Number	:	623-466-4159
Fax Number	:	623-439-7349

Provider Business Practice Location Address
First Line	:	11225 N 28TH DR STE C206
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5600
Country	:	US
Telephone Number	:	623-439-7472
Fax Number	:	623-439-7349

Authorized Official
Title or Position	:	CEO
Name	:	ELIAS MORAN JR.
Credential	:	LPC
Telephone Number	:	623-466-4159

Provider Enumeration Date	:	01/29/2019
Last Update Date	:	05/26/2025

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