Provider Demographics
NPI:1245996115
Name:GOOD HANDS BEHAVIOR
Entity type:Organization
Organization Name:GOOD HANDS BEHAVIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIMO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-317-6772
Mailing Address - Street 1:4038 E THISTLE LANDING DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6715
Mailing Address - Country:US
Mailing Address - Phone:480-590-0484
Mailing Address - Fax:
Practice Address - Street 1:4038 E THISTLE LANDING DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6715
Practice Address - Country:US
Practice Address - Phone:480-590-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health