Mulligan'S Manor, Inc.

LBN: Mulligan'S Manor, Inc.
Mulligan'S Manor, Inc. is an health care organization with primary practice located at 4701 S Lakeshore Dr Unit 1 , Tempe AZ 85282-7169. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Mulligan'S Manor, Inc. can be contacted via phone (480) 831-8721, or through Diaz, Jennifer Samayoa via phone (480) 831-8727.

Contact Information

Primary practice address
4701 S Lakeshore Dr Unit 1 Tempe AZ 85282-7169
Phone: (480) 831-8721
Fax: (480) 272-8708
Website:
Map and Directions
Authorized official contact:
Name: Diaz, Jennifer Samayoa Licensed Clinical Social Worker (LCSW)
Phone: (480) 831-8727

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Ambulatory Health Care Facilities / Community Health 261QC1500X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1427536770
LBN Legal business name Mulligan'S Manor, Inc.
DBA Doing business as
Authorized official Diaz, Jennifer Samayoa Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2018
Last updated Jul 30th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427536770 NPPES
Arizona MEDICAID 217581

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