Teen Out Reach Services
LBN: Teen Out Reach Services
Teen Out Reach Services is an health care organization with primary practice located at 544 S 96Th Pl , Mesa AZ 85208-2512. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Hospitals / Critical Access. Behavioral Health & Social Service Providers / Psychologist is the primary health care specialty.
Teen Out Reach Services can be contacted via phone (480) 696-0338, or through Johnson, Amanda Reane via phone (480) 696-0338.
Contact Information
Primary practice address
544 S 96Th Pl
Mesa AZ 85208-2512
Phone: (480) 696-0338
Fax:
Website:
Authorized official contact:
Name: Johnson, Amanda Reane Doctor of Medicine (MD)
Phone: (480) 696-0338
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Hospitals / Critical Access | 282NC0060X |
Profile Details
| NPI number | 1982289062 |
|---|---|
| LBN Legal business name | Teen Out Reach Services |
| DBA Doing business as | |
| Authorized official | Johnson, Amanda Reane Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Mar 10th, 2021 |
| Last updated | Jun 3rd, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982289062 | NPPES |
| Arizona | MEDICAID | 282NC0060X |
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