Organization Name: | HOPE BEHAVIORAL HEALTH RESIDENTIAL CARE |
NPI Number: | 1063837243 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER ODETOYE (OWNER) |
Mailing Address: | 22981 W Hopi St Buckeye |
State: | AZ US |
Postal Code: | 853268614 |
Phone Number: | 6235472243 |
Fax Number: | 6235472243 |
NPI Enumeration Date: | 02/25/2014 |
NPI Last Update Date: | 02/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0700X |
License Number: | BH4441 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Adult Development & Aging |
Taxonomy Definition: |