| Moonlight Treatment Center | |
|
341 E Camelback Rd Phoenix AZ 85012-1613 | |
| (770) 316-6495 | |
| Not Available |
| Full Name | Moonlight Treatment Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 341 E Camelback Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Felix Samuels (MEMBER) |
| Authorized Official Contact | 7703166495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonlight Treatment Center 9209 W Miami St Tolleson AZ 85353-5597 Ph: (770) 316-6495 | Moonlight Treatment Center 341 E Camelback Rd Phoenix AZ 85012-1613 Ph: (770) 316-6495 |
| NPI Number | 1396440616 |
|---|---|
| Provider Enumeration Date | 04/04/2023 |
| Last Update Date | 04/04/2023 |
| Certification Date | 04/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396440616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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