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NPI Code Detail

MEDICARE: HOPE & HEALING OUTPATIENT LLC

MEDICARE: HOPE & HEALING OUTPATIENT LLC
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
1261QM0850XAdult Mental Health Clinic/Center
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3251B00000XCase Management Agency
4261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
5251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1841968625
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPE & HEALING OUTPATIENT LLC
Provider Business Mailing Address
First Line : 67 S HIGLEY RD STE 103-208
Second Line :
City : GILBERT
State : AZ
Zip : 85296-1166
Country : US
Telephone Number : 480-868-8697
Fax Number : 602-374-3197
Provider Business Practice Location Address
First Line : 3512 N HIGLEY RD
Second Line :
City : MESA
State : AZ
Zip : 85215-9713
Country : US
Telephone Number : 480-868-8697
Fax Number : 602-374-3197
Authorized Official
Title or Position : MANAGING MEMBER
Name : CASSANDRA FORTSON
Credential :
Telephone Number : 480-868-8697
Provider Enumeration Date : 09/05/2021
Last Update Date : 03/04/2026

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Directions to “HOPE & HEALING OUTPATIENT LLC ” Practice Location

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