Organization Name: | NATIONAL MENTOR HEALTHCARE LLC |
NPI Number: | 1689098030 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERESA HOFFMEYER (AREA DIRECTOR/CLINICAL DIRECTOR) |
Mailing Address: | 12502 N 85th Ln Peoria |
State: | AZ US |
Postal Code: | 853815160 |
Phone Number: | 6027141865 |
Fax Number: | 6029561812 |
NPI Enumeration Date: | 02/05/2014 |
NPI Last Update Date: | 02/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | BH4440 |
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. |