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:
Map and Directions
Authorized official contact:
Name: Johnson, Amanda Reane Doctor of Medicine (MD)
Phone: (480) 696-0338

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1982289062 NPPES
Arizona MEDICAID 282NC0060X

Popular Providers