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Ideal Treatment Center Llc
Primary Care Nurse Practitioner in Phoenix, Arizona
NPI 1336837616

Ideal Treatment Center Llc is a Primary Care Nurse Practitioner based in Phoenix, AZ and is specialized in Primary Care. Ideal Treatment Center Llc practices in Phoenix, AZ. The NPI Number for Ideal Treatment Center Llc is 1336837616 and holds a License No. (Arizona).

The current practice location address for Ideal Treatment Center Llc is 1717 W Northern Ave Ste 107, Phoenix, AZ and can be reached out via phone at 602-612-2305.

Location: 1717 W Northern Ave Ste 107, Phoenix, AZ, 85021-5400
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336837616
Provider Name
Ideal Treatment Center Llc
Credential
Provider Entity Type
Organization
Address
1717 W Northern Ave Ste 107, Phoenix, AZ, 85021-5400
Phone Number
602-612-2305
Fax Number
Provider Enumeration Date
04/25/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1717 W Northern Ave Ste 107
City
Phoenix
State
Arizona
Zip
85021-5400
Phone Number
602-612-2305
Fax Number
person
Provider Business Mailing Address Details
Address
1717 W Northern Ave Ste 107
City
Phoenix
State
Arizona
Zip
85021-5400
Phone Number
602-612-2305
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Agencies
Classification
Case Management
Speciality
-
Taxonomy
251B00000X
License No.
()
Definition
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 6
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 7
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 8
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Rehabilitation, Substance Use Disorder
Taxonomy
261QR0405X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 9
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 10
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
()
Definition
Definition to come...
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