MEDICARE: ASCEND BEHAVIORAL HEALTH AND EMPOWERMENT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist
2	171M00000X	Case Manager/Care Coordinator
3	175T00000X	Peer Specialist
4	207Q00000X	Family Medicine Physician
5	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1811764319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCEND BEHAVIORAL HEALTH AND EMPOWERMENT LLC

Provider Business Mailing Address
First Line	:	6025 N 27TH AVE STE 567
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85017-1763
Country	:	US
Telephone Number	:	480-630-6691
Fax Number	:

Provider Business Practice Location Address
First Line	:	6025 N 27TH AVE STE 567
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85017-1763
Country	:	US
Telephone Number	:	480-630-6691
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARTIN FLORES
Credential	:
Telephone Number	:	602-695-5019

Provider Enumeration Date	:	12/05/2023
Last Update Date	:	12/05/2023

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