Provider Demographics
NPI: | 1770158768 |
---|---|
Name: | GAIE, AARON |
Entity type: | Individual |
Prefix: | |
First Name: | AARON |
Middle Name: | |
Last Name: | GAIE |
Suffix: | |
Gender: | M |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 8028 N 35TH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85051-5801 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 623-201-9183 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8028 N 35TH AVE |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85051-5801 |
Practice Address - Country: | US |
Practice Address - Phone: | 623-201-9183 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2021-05-23 |
Last Update Date: | 2021-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health | |
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
No | 332800000X | Suppliers | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | |
No | 3336M0002X | Suppliers | Pharmacy | Mail Order Pharmacy |
No | 347E00000X | Transportation Services | Transportation Broker | |
No | 373H00000X | Nursing Service Related Providers | Day Training/Habilitation Specialist | |
No | 385H00000X | Respite Care Facility | Respite Care | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 172A00000X | Other Service Providers | Driver | |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No | 276400000X | Hospital Units | Rehabilitation, Substance Use Disorder Unit | |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |