MEDICARE: ASCEND BEHAVIORAL HEALTH AND WELLNESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	103T00000X	Psychologist
3	323P00000X	Psychiatric Residential Treatment Facility
4	324500000X	Substance Abuse Rehabilitation Facility
5	363L00000X	Nurse Practitioner
6	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1780374348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCEND BEHAVIORAL HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	27818 N 24TH LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-4706
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	27818 N 24TH LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-4706
Country	:	US
Telephone Number	:	602-460-1449
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROBERTA ABDALLAH
Credential	:
Telephone Number	:	602-460-1449

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/08/2023

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Directions to “ASCEND BEHAVIORAL HEALTH AND WELLNESS ” Practice Location

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