Organization · NPI-2
A Different Outlook
Community/Behavioral Health · Mesa, AZ
NPI number1669191771
StatusActive
Last updated in NPPESAug 23, 2022
Details
- NPI
- 1669191771
- Entity type
- Organization (NPI-2)
- Legal business name
- A Different Outlook
- Organization subpart
- No
- Enumeration date
- Aug 23, 2022
- Certification date
- Aug 23, 2022
- Last updated
- Aug 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251300000X | Local Education Agency (LEA) | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
5646 E Main St Ste 5Mesa, AZ 85205-8800
Phone 602-675-9377
Mailing address
1923 E Broadway RdPhoenix, AZ 85040-2411
Phone 602-566-2249
Authorized official
Ashley Moore
Ceo
6025662249
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