Provider Demographics
NPI:1669142162
Name:HEALING TOUCH BEHAVIOR HEALTH LLC
Entity type:Organization
Organization Name:HEALING TOUCH BEHAVIOR HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ENOCH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-499-8685
Mailing Address - Street 1:32954 N PEBBLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-3410
Mailing Address - Country:US
Mailing Address - Phone:720-499-8868
Mailing Address - Fax:
Practice Address - Street 1:32954 N PEBBLE CREEK DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-3410
Practice Address - Country:US
Practice Address - Phone:720-499-8868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZBH6928Medicaid