| Hope & Healing Outpatient Llc | |
|
3512 N Higley Rd Mesa AZ 85215-9713 | |
| (480) 868-8697 | |
| (602) 374-3197 |
| Full Name | Hope & Healing Outpatient Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3512 N Higley Rd, Mesa, Arizona |
| Authorized Official Name and Position | Cassandra Fortson (MANAGING MEMBER) |
| Authorized Official Contact | 4808688697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope & Healing Outpatient Llc 67 S Higley Rd Ste 103-208 Gilbert AZ 85296-1166 Ph: (480) 868-8697 | Hope & Healing Outpatient Llc 3512 N Higley Rd Mesa AZ 85215-9713 Ph: (480) 868-8697 |
| NPI Number | 1841968625 |
|---|---|
| Provider Enumeration Date | 09/05/2021 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Medicare PECOS PAC ID | 4789031626 |
|---|---|
| Medicare Enrollment ID | O20231114002090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841968625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
| Provider Name | Walter P Vanhelder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720161706 PECOS PAC ID: 5799845889 Enrollment ID: I20081119000432 |
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