Bethel Hills Integrated Healthcare
Clinic/Center, Multi-Specialty in Phoenix, AZ. Organization (NPI-2).
NPI number1215698642
StatusActive
Last updated in NPPESJan 7, 2022
Details
- NPI
- 1215698642
- Entity type
- Organization (NPI-2)
- Legal business name
- Bethel Hills Integrated Healthcare
- Organization subpart
- No
- Enumeration date
- Jan 7, 2022
- Certification date
- Jan 5, 2022
- Last updated
- Jan 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261Q00000X | Clinic/Center | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 261QP2300X | Clinic/Center, Primary Care | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Other names
- Bethel Hills Clinic (Doing Business As)
Practice location
13838 S 46th Pl Ste 340Phoenix, AZ 85044-7805
Phone 480-597-7903 · Fax 480-597-7903
Mailing address
13838 S 46th Pl Ste 340Phoenix, AZ 85044-7805
Phone 480-597-7903 · Fax 480-597-7903
Other practice locations
6150 Transverse Dr Ste 103
Las Vegas, NV 89146-1170
Las Vegas, NV 89146-1170
Phone 702-530-4531 · Fax 702-660-7123
Authorized official
Olubukola Komolafe
Medical Director
8325423181
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