Organization Name: | MOUNTAIN TOP BEHAVIORAL HEALTH SERVICES, LLC |
NPI Number: | 1356715593 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | OLUGBENGA ADEDOLAPO TEPEDE (CEO/PROGRAM DIRECTOR) |
Mailing Address: | 7319 W Maldonado Rd Laveen |
State: | AZ US |
Postal Code: | 853397001 |
Phone Number: | 6233636408 |
Fax Number: | 8888437281 |
NPI Enumeration Date: | 11/27/2015 |
NPI Last Update Date: | 11/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | BH4710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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. |