Provider Demographics
NPI:1356805816
Name:ARIZONA'S NEW HOPE, PLLC
Entity type:Organization
Organization Name:ARIZONA'S NEW HOPE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:623-466-4159
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-0129
Mailing Address - Country:US
Mailing Address - Phone:623-466-4159
Mailing Address - Fax:623-439-7349
Practice Address - Street 1:919 N DYSART RD STE F
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-1711
Practice Address - Country:US
Practice Address - Phone:623-439-7472
Practice Address - Fax:623-439-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ480098Medicaid