Provider Demographics
NPI:1679282586
Name:BEAM OF LIGHT HEALTH SERVICES INC
Entity Type:Organization
Organization Name:BEAM OF LIGHT HEALTH SERVICES INC
Other - Org Name:ALOWAI BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOWHARAH
Authorized Official - Middle Name:N
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MHRM
Authorized Official - Phone:602-390-5227
Mailing Address - Street 1:13832 N 32ND ST STE A106
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5613
Mailing Address - Country:US
Mailing Address - Phone:602-390-5227
Mailing Address - Fax:
Practice Address - Street 1:13832 N 32ND ST STE A126
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5613
Practice Address - Country:US
Practice Address - Phone:602-390-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-18
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health