Organization Name: | SOVEREIGN HEALTH OF PHOENIX, INC. |
NPI Number: | 1174950471 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RISHI BARKATAKI (PRESIDENT) |
Mailing Address: | 111 S Hearthstone Way Chandler |
State: | AZ US |
Postal Code: | 852265010 |
Phone Number: | 3024541265 |
Fax Number: | 3024547868 |
NPI Enumeration Date: | 10/01/2013 |
NPI Last Update Date: | 02/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | 2005211229 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |