| NPI | 1023532025 |
|---|---|
| Doing Business As | 99TH AVE ACT |
| Entity Type | Organization |
| Authorized Contact | JOHN HOGEBOOM President/CEO 480-831-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AZ OTC5972) |
| Additional Taxonomies | 251B00000X Case Management (Licence: AZ OTC5972) |
| 251S00000X (Licence: AZ OTC5972) | |
| 261QH0100X Clinic/Center, Health Services (Licence: AZ OTC5972) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: AZ OTC5972) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-04-07 |