Provider Demographics
NPI:1558797654
Name:POSITIVE MOVEMENT,LLC
Entity Type:Organization
Organization Name:POSITIVE MOVEMENT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:HOMER
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-516-5554
Mailing Address - Street 1:2303 N 44TH ST STE 14-1118
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-2446
Mailing Address - Country:US
Mailing Address - Phone:313-516-5554
Mailing Address - Fax:480-365-0763
Practice Address - Street 1:2303 NORTH 44TH ST #14-1118
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-2442
Practice Address - Country:US
Practice Address - Phone:313-516-5554
Practice Address - Fax:480-365-0763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-20
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH5067320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness